Hole in Heart: Symptoms, Causes and Treatment

Last Updated on: 10 July 2026

A hole in the heart may sound frightening, but not every case is serious. Many small heart holes cause no symptoms and may even close on their own, while larger ones can lead to breathlessness, fatigue, frequent chest infections, or heart rhythm problems if left untreated. The good news is that modern heart hole treatment is highly effective, with many patients living normal, healthy lives after timely care.

In this guide, we’ll answer the questions patients search for most, including:

• What is a hole in the heart?
• What are the heart hole symptoms?
• What causes a hole in the heart?
• Can a hole in the heart heal itself?
• What is the best heart hole treatment?
• What are the symptoms of a hole in heart in adults?
• Can you live with a hole in your heart?

Quick Facts About Hole in Heart

What Is a Hole in Heart?

A hole in heart isn’t a medical diagnosis by itself. Instead, it’s a general term used for defects in the heart’s internal wall (septum).

The two most common types are:

Atrial Septal Defect (ASD)

An ASD is a hole between the upper chambers (atria) of the heart. Blood from the left atrium leaks into the right atrium, increasing blood flow to the lungs.

Ventricular Septal Defect (VSD)

A VSD is a hole between the lower chambers (ventricles). Because the left ventricle pumps at much higher pressure, blood crosses into the right ventricle, making the heart work harder.

Types of Hole In The Heart:

Different types of holes can be raised in the heart including:

• Patent Foramen Ovale (PFO): All fetuses have a natural hole in the heart during development that will close itself. But in some fetuses, the hole does not fuse even after birth, which is known as patent foramen ovale. 20-25% of adults have PFO.
• Atrial Septal Abnormalities: In this type, a hole is formed in between the upper chambers of the heart (atria). The hole is formed in the atrial septum. A hole can sometimes remain when the fetus’s heart forms and the septum does not close completely. There are different types of atrial septal abnormalities such as primum (heart hole is developed near the bottom of the septal wall, secondum (heart hole develops near the middle of the septal wall), multifenestrated( consists of multiple holes in the septal wall), and sinus venous (heart hole appears near the superior and inferior vena cava).
• Ventricular Septal Abnormalities: In this type, a hole is formed in the wall separating the ventricles of the heart. The different types of ventricular septal abnormalities are muscular (heart hole is seen in the muscular tissue between ventricles), perimembraneous (hole appears near the middle of the heart, outlet and supracristal (hole develops near the aorta or pulmonary arteries), post-infarction (a hole that develops after a heart attack).

What Causes a Hole in the Heart?

One of the most common questions online is:

“What causes a hole in the heart?”

In almost all cases, the defect develops before birth, while the baby’s heart is forming.

Doctors still don’t know the exact reason in every child, but several factors increase the risk.

• Genetics: a family history of chromosomal abnormalities may predispose to the development of a hole in the heart
• Environmental factors: These include exposure to certain chemicals or drugs during pregnancy
• Medical conditions: Pregnant people with medical conditions such as diabetes, rubella, maternal phenylketonuria, and lupus are at a higher risk of having a baby with congenital heart defects
• Certain medications: Taking some medicines during pregnancy may cause a heart hole. this includes angiotensin-converting-enzyme inhibitors to control high blood pressure, statins, thalidomide, lithium, isotretinoin
• Smoking: Cigarette smoking during pregnancy may cause a hole in the heart of fetus
• Alcohol misuse: Excess alcohol consumption may cause a hole in the fetal heart

What Causes Hole in Heart in Adults?

Adults don’t usually develop a congenital hole later in life.

Instead:

• the defect was present since birth but remained undetected, or
• in extremely rare cases, a severe heart attack can tear the wall between the ventricles and create an acquired VSD.

So when people ask “what causes hole in heart in adults,” the answer is usually a congenital defect discovered later, not one that suddenly developed.

Read Also: Cost of Pediatric Cardiac Surgery in India

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What Are The Symptoms of A Hole In The Heart?

One of the biggest misconceptions is that everyone with a hole in the heart feels sick.

In reality, small defects may cause no symptoms for years and are often discovered during a routine examination when a doctor hears a heart murmur.

Larger defects can produce symptoms because the heart and lungs are handling more blood than normal.

Common heart hole symptoms include:

• Shortness of breath, especially when exercising
• Feeling tired, especially after performing activities
• Swelling in feet, legs, or belly area
• Irregular heartbeats (arrhythmias)
• Palpitations (feeling of a skipped heartbeat or feelings of a quick, pounding or fluttering heartbeat)

The symptoms experienced for a ventricular septal defect depend on the size of the hole and the presence of any other heart diseases. Following are the symptoms of ventricular septal defect:

• Poor eating
• Slow or no physical growth rate
• Getting tired more often
• Breathlessness or fast breathing
• Heart murmur
• Shortness of breath, especially when exercising

People with Patent Foramen Ovale (PFO) do not show any noticeable symptoms or conditions. But in some cases, it may result in:

• Severe headaches (migraine)
• Stroke
• Transient ischemic attack

Symptoms of Hole in Heart in Adults

Many people assume congenital heart defects always appear during childhood. That’s not true.

A small ASD may remain unnoticed until adulthood.

Symptoms of hole in heart in adults include:

How Is a Hole in the Heart Diagnosed?

Doctors often first suspect the condition after hearing a heart murmur.

Some of the congenital heart defects such as holes in the heart are found before or soon after the baby is born. But the smaller holes will remain undetected till later stages of life. If you have a family history of heart disease, or if the doctor hears a heart murmur while examining, he or she will ask you to perform some tests to rule out the exact cause. These diagnostic tests include:

• Echocardiogram: This is the main test used to diagnose both atrial septal defect and ventricular septal defect. A picture of the heart in motion is obtained using sound waves. It shows the structure of heart chambers and valves. Along with this how blood moves through the blood vessels is also seen in echocardiograms.
• Chest X-ray: A chest X-ray helps to see the structure of the heart and lungs
• Electrocardiogram (ECG):
• ECG helps to detect the electrical activity of the heart. It is a quick and painless test that discloses how fast and how slowly the heart beats.
• Pulse oximetry: A pulse oximeter is a sensor device attached to your fingertips to record the amount of oxygen in the blood. Too little oxygen values represent underlying heart or lung problem.
• Cardiac magnetic resonance imaging scan: Detailed images of the heart are disclosed with the help of radio waves and a strong magnetic field. It is performed if other tests don’t provide a sure diagnosis.
• Computerized tomography scans: Detailed images of the heart are disclosed with the help of a series of X-rays, and are performed if other tests are not enough to come to a proper diagnosis.
• Cardiac catheterisation: This helps doctors to determine the function of the heart valves and chambers.

Apart from these tests, doctors may also diagnose congenital heart abnormalities during pregnancy using a fetal echocardiogram. This allows healthcare providers to visualize the fetal heart. It is done during pregnancy for people who have a congenital history of heart disease, taking medications or having diseases that may increase the risk of getting heart defects.

Can a Hole in Heart Heal Itself?

Yes, but only in certain situations.

Small ventricular septal defects frequently close naturally during early childhood.

Some small atrial septal defects may also close.

Larger defects generally remain open and require regular follow-up or treatment.

Chances of spontaneous closure

Heart Hole Treatment

The right heart hole treatment depends on:

• defect type
• size
  symptoms
• age
• heart function
• lung pressure

Not every patient requires surgery.

Treatment options at a glance

Evaluating these factors your doctor will prescribe medications, and in severe cases, they may recommend surgery for you.

Treatment for atrial septal defect:

An atrial septal defect during birth time will close over a period of time. If it is not causing any symptoms, regular health checkups are only needed. Treatment includes:

• Medications: medicines will not help to repair the hole in the heart, but they may help to reduce the symptoms. These medicines include beta blockers to control heartbeat, anticoagulants or blood thinners to lower the risk of blood clots, and diuretics to reduce fluid build ups.
• Surgery or other Procedures: It is done to repair a medium to large atrial septal defect to prevent complications. It involves closing the hole in the heart, which can be done in two ways.
• Catheter-Based Repair: This is done to fix the secundum type of atrial septal defects. Through the groin area, a thin, flexible tube called a catheter is put into a blood vessel. Then this tube is guided into the heart. A mesh patch or plug goes through the catheter. The patch is used to close the hole. Later heart tissue grows around the patch, closing the hole for life.
• Open Heart Surgery: this involves making a cut through the chest wall to get to the heart. The surgeon closes the holes using patches. Open-heart repair surgery is the only way to fix primum, sinus venosus and coronary sinus atrial defects.

Treatment for Ventricular Septal Defect:

The treatment includes regular checkups, medications and surgeries depending on the type and number of holes.

• Medications: Medications will not help to repair the holes but help to prevent complications. Oxygen, and diuretics, are usually prescribed.
• Surgeries and other procedures: Surgeries are done to repair medium to large-sized holes. Most of the surgeries for babies with VSD are done in their first year. The surgery can be done in 2 ways.
• Open heart surgery: Most of the ventricular septal defects are repaired using open heart surgery. In this, the surgeon uses a patch or stitches to close the hole between the lower heart chambers.
• Catheter procedure: some types of VSD can be repaired using catheters without doing open heart surgeries.

Can You Live with a Hole in Your Heart?

Yes.

Many people live their entire lives with a small hole in the heart without complications.

Others require treatment because the defect gradually enlarges the workload on the heart.

The key is regular follow-up with a cardiologist.

How Long Can You Live with a Small Hole in Your Heart?

If the defect is small and doesn’t affect heart function, many people have a normal life expectancy.

Problems usually arise when:

• the hole is large,
• causes significant blood shunting,
• or leads to pulmonary hypertension or heart failure.

That’s why routine monitoring is important, even if you feel well.

Conclusion

A hole in the heart may sound frightening, but today’s outlook is far better than many people imagine. Many small defects close naturally, while larger ones can often be treated successfully with minimally invasive procedures or surgery.

The most important step is early diagnosis. If you or your child has a heart murmur, unexplained breathlessness, poor growth, or recurrent chest infections, don’t ignore these signs. An echocardiogram can usually confirm the diagnosis and help determine whether observation or treatment is the best option.

FAQs:

Q1: Can a hole in the heart heal itself?

A: A small hole in the heart may heal itself over some time. Some will not close, but will not increase in size and limit activities also. But medium to large-sized holes require medical treatments to heal.

Q2: What is the success rate of heart hole surgery?

A: Depending upon the disease severity, a 98% success rate is observed after heart hole surgery completion with only a few cases leading to complications.

Q3: How long can a patient live with a heart hole?

A: In some cases, patients with small holes such as ASD conditions live for 80 years without any treatment. However, the average life expectancy of an untreated ASD patient is 50 years.

Q4: What are the early symptoms of a hole in the heart?

A: Early symptoms include fatigue, shortness of breath, irregular heartbeat, swelling in legs, and frequent lung infections.

Q5: Can a hole in the heart be cured without surgery?

A: Small holes may close naturally, especially in children. Larger defects often require minimally invasive closure or surgery.

Q6: How much does hole in heart surgery cost in India?

A: The cost typically ranges between ₹2,00,000 – ₹5,00,000 depending on hospital, procedure, and patient condition.

Medical Disclaimer: This article is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult a qualified cardiologist or healthcare provider for personalized recommendations.