Hole in the heart – causes, symptoms and treatment

Table of contents

The most important facts

  • In the case of a hole in the heart, the otherwise separate chambers of the heart or of the heart are the Atria through an Opening. As the blood flows through it, that doesn’t belong there.
  • Usually such holes are innate, because you have not closed during the fetus.
  • In rare cases, they are caused by heart attacks.
  • Small holes are often not treated, if they cause no discomfort.
  • The closure of small holes in the Atria is carried out today mainly minimally invasive using a catheter.
  • The Sealing of holes in the heart chambers is a need for open-heart surgery.

As it comes to a hole in the heart?

The halves of the Heart each consist of a ventricle and an atrium. Deoxygenated blood brings the circulation of the blood through the right atrium into the right ventricle and from there into the lungs. The breathing air supplies it with fresh oxygen, and the blood continues to flow through the left atrium in the left chamber. The Aorta transports the blood back into the body. Partitions separate the Atria and ventricles from each other. Toxins, infections during pregnancy and genetic defects can lead to the vagina walls. The septum grows together in the Embryo, from above and below. In the case of a hole in the septum closes completely.

The ventricular septal defect (VSD)

Here the hole is in the septum between the right and left Ventricle. This Opening is small, then oxygen-rich blood from the left to the right chamber and from there into the lungs. The lung is thus stronger than normally perfused.

Large holes increase the pressure in the right heart chamber and thereby the pressure in the arteries of the lungs. Affected children suffer from this blood pressure shortness of breath and have to breath faster.

The atrial septal defect (ASD)

The second most common congenital malformation of the heart is an atrium septal defect. Here is a hole in the septum between the Atria. The oxygen-rich blood to flow at a higher pressure now from the left to the right atrium. The pressure in the lungs rises, the right atrium and the right ventricle can enlarge. In the case of smaller holes show no symptoms usually in the long time, the risk of a thrombosis or a heart rhythm disorder.

The Persistent Foramen ovale (PFO)

Here is a hole between the Atria, and thus a direct connection between the pulmonary and systemic circulation. The blood passes directly from the pulmonary veins into the Aorta. Usually, this Opening in the first days after birth. If not, this hole small children, little problems, because the pressure in the lungs is not high. With age, this pressure increases. For young people and adults with a PFO activities with strong variations of pressure are dangerous to life. This is particularly true for scuba diving and mountain climbing. Also, the fly is risky. Many cases of death among divers go back to an undetected hole in the heart Atria.

What can you do?

Pregnant can, already prior to the birth of a child with ultrasound to examine, whether the fetus suffers from such heart failure.


In the case of larger holes typical symptoms manifest themselves in the infants. You drink to take a little bit of weight and suffer from shortness of breath. On children’s diseases specialist cardiologist to clarify whether there is a septal defect.


The therapy depends on the Severity of the defect, its size and its location. It is an enormous heart defect, then this surgically removed. An ASD may, however, in eight out of ten cases, minimally invasive fixed. A smaller screen will be introduced with a catheter, and this Umbrella then closes the hole. This is only possible, if the hole is in the middle of the septum. If not, there must be a procedure of open heart.

Hole in the heart in the elderly

One such heart defect is usually congenital, but in rare cases, even in old age. Here it is, as a rule, to a damage of the chamber wall, caused by a heart attack of the vagina. In the case of a late detected infarction no oxygen reaches the heart and leads to the death of heart tissue. This can also relate to the substance of the septum. The dead tissue scars.

The heart wall can aussacken, and sometimes an Opening in the septum between the right and left ventricle. Also in the case of a surgery on the open heart as a hole.
Sometimes turns in older people, but as a result of a heart hole, the
Skin blue or you suffer from shortness of breath. Here, however, is a late consequence of a congenital hole in the heart. At a young age the power of the heart is stronger and so a mistake can be better balanced. In advanced years, the heart performance and now have to put the complaints.

Treatment – Catheter and dual screen

Such a hole with a double shade made of Nitrol close. This screen is inserted surgically with a probe on the bar. Usually a local anaesthetic is sufficient, unless the Patient insists on General anesthesia. In the case of the Affected do not experience pain. The Procedure takes about 30 minutes.

To close a septal defect in the atrial, a special catheter from the right atrium through the hole into the left atrium, and pulls a wire through the catheter into the left atrium. Along the wire is now introduced to a measuring catheter, in order to identify the dimensions of the Opening. According to these dimensions, the size of the closure.

The doctor removes the catheter and pulls the locking tool into the guide catheter. The left part of the shutter opens when you Push by itself. By the guide catheter is withdrawn, clings to the closure of the atrial septum. The guide catheter is pulled back fully, open also the right part of the closure. In the following three months, the Patient takes medication for a while until the tissue has overgrown the screen.

When to consider a closure?

An open Foramen ovale, which causes no discomfort, is usually closed. Differently it looks, if the blood clot from the leg or from the basin through the Opening in the large blood circulation. Then, blood vessels can clog in the brain or other organs, with serious consequences, such as, for example, a stroke. The very rare Defects in the atrial septum are also normally closed. The urgent need for a closure is recommended, however, as when you open the Foramen when blood clots form.


Small Defects in the atrial and the open Foramen ovale or with an ECG with an x-ray image. Larger holes at the atrium, the cardiologist to detect noise, eye-catching Heart on the ECG or on the x-ray image. Heart holes are found from the heart ultrasound much more effective.


In the case of catheter complications closures are extremely rare. In the past, it came in about six percent of the cases clots of blood. This is but with today’s caps is hardly the case, and these clots occur in only one out of a hundred cases Treated. Theoretically, it is also possible that the screen is washed into the circulation and the tissue is damaged. Practically, this is as good as never. Ten percent of those Affected have, in the weeks after the procedure, disturbances of atrial rhythm. These occur because the Atria are mechanically irritated. Problems do not arise as a result.

You may go in for sports?

People with an unsealed hole in the heart can often operate almost all types of sports, if the hole is small. Should you this deny, but in any case, with your doctor. In the case of a small Defect, you can both moderate sports such as Golf, but also sports such as football or Cycling, make an effort to operate. In the case of a larger hole that is not so easy – particularly, if the hole is under-supplied with oxygen. Recognizable, that is, if you start in the truest sense of the word blue, that is, their skin discolored. You should choose in this case, no sports, the high oxygen supply, such as, for example, long-distance running. Performance sports is in the case of severe heart defects is not possible, recreational sports. The are the first choice for light Hiking.

A hole in the heart prevent?

A hole in the heart you can’t prevent, since it is mostly innate. Acquired Openings in the heart are a result of heart attacks. At most, you can prevent a heart attack, through regular examinations in the cardiology practice, refraining from cigarettes and alcohol, and adequate exercise. (Dr. Utz Anhalt)