You may have heard of the term ‘hole in the heart’. Many are unaware of what it means, and whether it is a serious condition or not.
Here we take a brief look at the meaning of the term.
What is the normal structure of the heart
Before we discuss the topic at hand, it is worth revisiting the normal structure in the heart.
The heart consists of 4 chambers – 2 on the top and 2 at the bottom. The top chambers are called the atria, while the bottom are the ventricles.
The heart is also divided into a left and right part by a muscular tissue called the septum. The septum at the top of the heart is called the inter-atrial septum (or atrial septum) and the one in between the ventricles is called the inter-ventricular septum (or ventricular septum)
The right side of the heart receives blood that is poor in oxygen from all parts of the body and pumps it to the lungs. In the lungs, the blood get enriched with oxygen, and this blood returns to the left side of the heart. The left heart then pumps the blood back to the rest of the body.
What is a hole in the heart?
A hole in the heart refers to a small hole that is seen in the septum. It is a birth defect that develops during the growth of the baby in the womb.
A hole in the atrial septum is called an atrial septum defect (ASD).
A hole in the ventricular septum is called a ventricular septal defect (VSD).
Both ASD and VSD permit the flow of blood from the left side to the right side of the heart. This means that oxygen rich blood mixes with oxygen poor blood.
What are the problems with holes in the heart?
Small holes tend not to cause any problems, and in 1 out of every 3 cases the holes will close by themselves.
Large ASDs can start to cause symptoms early in life, and children may experience tiredness, chest infections and breathing problems. A murmur (a soft ‘whooshing’ sound) may be heard with a stethoscope. Diagnosis of a large ASD can be made through echocardiography. It usually requires treatment though surgical means.
Similarly, a large VSD can also cause symptoms such as breathing difficulty. Medical and surgical treatment will be needed in most cases.
If a hole in the heart is detected, make sure you get the right advice on how it can be managed.
Can holes in the heart be picked up before birth of the baby?
Yes and no. The development of the heart within the womb is complete within 6 weeks. However, at such an early stage, small defects may not be visible at this time, and ultrasounds that assess the heart are performed at 12 weeks (the heart is clearly seen then). A small defect will not be visible. However, detecting a large defect on antenatal ultrasound indicates that there is a serious problem, and the right steps need to be taken to manage this. Speak to your doctor for more information.
If the defect is large and is likely to cause serious problems to the health of the newborn, doctors may discuss options such as termination of pregnancy. However, this will only be done if it is ethical and following discussion with the family. Sensitive issues such as religious beliefs will also be taken into consideration.
Are holes in the heart genetic?
There is some research available regarding this, and it is suggested that genetics may play a role in the development of holes in the heart. However, it is not completely clear yet.
How can I deal with the problem?
After the birth of the baby, regular visits to the pediatrician is recommended. Any defects in the heart can be detected early and treated appropriately.
Bear in mind that most small holes in the heart tend to close by themselves. Children with small holes in the heart can be treated like any other child and allowed to participate in the activities that they wish to. However, a small number of children can develop infections around these holes due to the turbulent flow around the hole. Maintaining good dental hygiene is recommended and antibiotics may be recommended before any dental work is performed.
There may be certain precautions that need to be taken if the child has a hole in the heart. Speak to your doctor to find out more.