Key Points

• Holes in the heart are simple congenital heart defects. Congenital heart defects are problems with the heart's structure that are present at birth. These defects change the normal flow of blood through the heart.
• Your heart has two sides, separated by an inner wall called the septum. An atrial septal defect (ASD) is a hole in the upper part of the septum, which separates the atria. A ventricular septal defect (VSD) is a hole in the lower part of the septum, which separates the ventricles.
• ASDs and VSDs allow blood to pass from the left side of the heart to the right side. This means that oxygen-rich blood can mix with oxygen-poor blood. As a result, some oxygen-rich blood is pumped to the lungs instead of out to the body.
• ASDs and VSDs can be small or large. Many small ASDs and VSDs close on their own as the heart grows during childhood. Large holes in the septum are less likely to close on their own over time.
• Doctors don't know what causes most holes in the heart. Heredity may play a role in some heart defects. Also, children who have genetic disorders, such as Down syndrome, often have congenital heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.
• A heart murmur (an extra or unusual sound heard during a heartbeat) is the most common sign of both ASD and VSD. If an ASD or VSD causes heart failure, signs and symptoms may include fatigue (tiredness), tiring easily during physical activity, shortness of breath, a buildup of blood and fluid in the lungs, and a buildup of fluid in the feet, ankles, and legs.
• Many babies who are born with ASDs have no signs or symptoms.
• Doctors usually diagnose holes in the heart based on results from a physical exam and tests and procedures. The exam findings for an ASD often aren't obvious, so the diagnosis sometimes isn't made until later in childhood or even adulthood. VSDs have a very distinct heart murmur, so a diagnosis usually is made in infancy.
• Many holes in the heart don't need treatment, but some do. Most holes in the heart that need treatment are repaired in infancy or early childhood. Sometimes, adults are treated for holes in the heart if problems develop.
• The treatment your child receives depends on the type, location, and size of the hole. Other factors include your child's age, size, and general health. Holes in the heart are treated with catheter procedures or surgery.
• The outlook for children who have ASDs or VSDs is excellent. Advances in treatment allow most children who have these heart defects to live normal, active, and productive lives with no decrease in lifespan.
• Many children who have ASDs or VSDs need no special care or only occasional checkups with a cardiologist (heart specialist) as they go through life.