What is a hole in the heart?

Chances are good you may know someone that has been diagnosed with a hole in the heart. In fact, maybe either you or your child has been given this diagnosis! For many people without medical experience, this can be confusing. What does a hole in the heart actually mean?

One of the most common problems that a pediatric cardiologist deals with on a regular basis are "holes" in the heart. In this setting, a "hole" typically refers to an opening in one of the walls separating chambers of the heart. A ventricular septal defect, or VSD, is the most common hole in the heart. A VSD is an opening in the ventricular septum, the wall separating the lower 2 chambers from one another. An atrial septal defect, or ASD, is the second most common type of hole in the heart. An atrial septal defect is a hole in the atrial septum, the wall separating the upper 2 chambers from one another.

A ventricular septal defect is actually the most common congenital heart defect. Fortunately most of them are small and insignificant. A good portion may spontaneously close over time. Large ventricular septal defects may cause symptoms and ultimately require surgery to close them. The same goes for atrial septal defects.

The term "hole in the heart" certainly can be confusing. I've had families with children diagnosed with holes in the heart come in very confused, thinking that blood must be leaking out of the heart into the chest cavity somewhere. For many people it may be natural to think of the term "hole in the heart" as meaning something like a hole in a basketball with air leaking out! I always take as much time as possible to clarify this when talking to families. In fact, the use of diagrams and pictures is very important in my practice. This comes in especially handy when talking about holes in the heart. Being able to show the family that the hole is actually inside the heart, and in one of the walls separating chambers can be very useful.

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