Hole in the Heart | William G. & Mary A. Ryan Center for Heart & Vascular Medicine | Loyola Medicine

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Hole in the Heart

Overview and Facts about Hole in the Heart

A ventricular septal defect, or a hole in the heart, is a heart condition characterized by a hole occurring between the walls separating the lower heart ventricles. Your heart ventricles are the lower chambers of your heart that continuously contract to pump blood throughout your body. Holes in these ventricles can range from the simple to complex, with simple holes being the most treatable and least likely to cause symptoms. However, any kind of hole can cause health complications at any point in life, even as early as birth, and can occur in both males and females.

Signs and Symptoms of Hole in the Heart

A simple hole in the heart typically presents no symptoms. Complex holes, on the other hand, produce the most critical symptoms. These require medical intervention. A hole in the heart causes the heart to work harder because blood is not adequately pumped from the heart to other parts of the body, such as the lungs.

Depending on the severity or complexity of your condition, key signs and symptoms may include:

  • Rapid or hard breathing
  • Rapid or easy fatigue during physical activity (or during feeding for infants)
  • Stroke
  • Weakness
  • Frequent lung or respiratory infections
  • Heart murmur
  • Abnormal or skipped heartbeats
  • Swelling of legs, stomach, or feet
  • Little to no weight gain (for infants)

Causes and Risk Factors of Hole in the Heart

Why holes in the heart occur has not been definitively determined. However, it is believed that in some cases individuals with family histories of heart defects are more likely to develop a ventricular septal defect. Genetic factors, such as changes in DNA that may or may not be inherited and genetic abnormalities like down syndrome may also be a cause, as could be developmental factors, like heart development complications during pregnancy.

Other possible causes and risk factors include:

  • Exposure to certain chemicals or substances during pregnancy, such as tobacco smoke or certain medications
  • Being male, as it is slightly more common in males than females
  • Diabetes or phenylketonuria during pregnancy
  • Rubella infection during pregnancy

Tests and Diagnosis of Hole in the Heart

Holes in the heart are often discovered at birth or during pregnancy. A fetal echocardiography, which is an ultrasound technique, can precisely detect a hole in the heart as early as 18 to 22 weeks into pregnancy. Pulse oximetry testing is used to determine if there are low blood oxygen levels in newborns.

Echocardiography is used to identify ventricular septal defects in children and adults. Cardiac catheterization measures pressure and oxygen levels inside the heart and blood vessels. Chest X-rays and cardiac magnetic resonance imaging (MRI) are also used to identify heart defects.

Treatment and Care for Hole in the Heart

Regular prenatal care, limited exposure to environmental toxins like tobacco and alcohol and proper medication during pregnancy may help prevent ventricular septal defects. Appropriate steps to avoid infection during pregnancy, such as remaining up to date on vaccines, may also help prevent ventricular septal defects. A balanced diet with a sufficient amount of folic acid is another important prevention measure.

In general, treatment for ventricular septal defects depends on the size and location of the hole, the affected person’s age and if other birth defects are present. If the hole is treatable, then cardiac catheterization or open-heart surgery may be used to repair or close the hole. Symptoms typically abate once the surgery is complete.