Atrial Septal Defect

Although many holes in the heart don't need treatment, some do. These days, 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.

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What Causes Holes in the Heart?

Mothers of children born with an atrial septal defect (ASD), a ventricular septal defect (VSD), or another type of heart defect often think that they did something wrong during the pregnancy to cause the problem. However, 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.

Scientists continue to search for the causes of congenital heart defects.

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What Are the Signs and Symptoms of Holes in the Heart?

Atrial Septal Defect

A heart murmur (an extra flow sound associated with the heartbeat) is the most common sign of an atrial septal defect (ASD). Often, it’s the only sign. However, not all murmurs are a sign of a congenital heart defect.

Many healthy children have heart murmurs, which are innocent, normal sounds of blood flow through the heart.

A doctor can tell by listening whether a murmur is a normal flow sound or a sign of a heart problem. Many babies born with ASDs have no signs or symptoms.

If a large ASD isn’t repaired, the extra blood flow to the right side of the heart can eventually damage the heart and lungs, causing heart failure.

This doesn’t occur until adulthood. Signs and symptoms of heart failure can include:

• Fatigue or tiring easily during exercise or activity

• Shortness of breath

• A buildup of blood and fluid in the lungs

• A buildup of fluid in the feet, ankles, and legs

Ventricular Septal Defect

A heart murmur is usually present in ventricular septal defect (VSD) and may be the first and only sign of this defect. The heart murmur is often present right after birth in many infants, but it may not be heard until the baby is 6 to 8 weeks old.

Most newborns who have VSDs don’t have heart-related symptoms. However, a baby with a medium or large VSD can develop heart failure. Signs and symptoms of heart failure usually appear during the baby’s first 2 months of life. The signs and symptoms of heart failure from VSD are similar to those listed above for ASD, but they occur in infancy.

The major sign of heart failure is difficulty feeding and poor growth. VSD symptoms are rare after infancy because the defect either decreases in size on its own or is repaired.