A hole in the heart is a type of simple congenital heart defect – a problem with the heart's structure that is present at birth. Congenital heart defects change the normal flow of blood through the heart.
The heart has two sides, separated by an inner wall called the septum. Some babies are born with a hole in the upper or lower septum. A hole in the septum can 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, causing the oxygen-rich blood to be pumped to the lungs a second time.
A hole in the septum between the heart's two atria is called an atrial septal defect (ASD). Small ASDs allow only a little blood to flow from one atrium to the other. Small ASDs don't affect the way the heart works and therefore don't need any special treatment. Many small ASDs close on their own as the heart grows during childhood. Medium to large ASDs allow more blood to leak from one atrium to the other, and they are less likely to close on their own.
A hole in the septum between the heart's two ventricles is called a ventricular septal defect (VSD). An infant born with a VSD may have a single hole or more than one hole in the wall that separates the two ventricles.VSDs can be small or large. A small VSD doesn't cause problems and may often close on its own. A large VSD is less likely to close completely on its own, but it may get smaller over time. Large VSDs often cause symptoms in infants and children, and surgery is usually needed to close them.
Over the past few decades, the diagnosis and treatment of ASDs and VSDs have greatly improved. As a result, a child with a simple heart defect can grow to adulthood and live a normal, active, and productive life because his or her heart defect closes on its own or has been repaired. Although many holes in the heart don't need treatment, some do. 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
Most of the time, doctors don't know why these congenital heart defects develop.
Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect is slightly more likely than other people to have a child with the problem. In very rare cases, more than one child in a family is born with a heart defect. Children with genetic defects often have congenital heart defects. An example of this is Down syndrome – half of all babies with Down syndrome have congenital heart defects. Research is still on to search for the causes of congenital heart defects.