Hole in the heart – Common cardiac problems in children
Many a times parenrs are told that the kid has a hole in the heart. What does a hole in the heart mean? Parents have many doubts and apprehensions about what actually that hole in the heart mean. Sometimes this term is used as a general term to suggest many diseases. Common problems which present as hole in the heart are:
- ASD – Atrial septal defects
- VSD – Ventricular septal defects
- PDA – Patent ductus arteriosus
- Multiple combinations of these defcts and other defects
Usually such diseases are treatable and completely correctible. I will explain these diseases or defects briefly and in a patient friendly language.
Normally our heart has two atria (left and right), two ventricles (left and right), two great arteries (aorta & pulmonary artery) and four valves (mitral, aortic, tricuspid & pulmonary). A hole in the heart can be a result of problems in one of these structures.
ASD (Atrial Septal Defects):
The left and the right atria are separated by the inter-atrial septum (IAS). When there is incomplete development of the IAS it results in ASD. An ASD can be an isolated problem or it may be associated with other cardiac problems. Isolated ASDs are completely correctible. Some ASDs are closed by percutaneous devices by cardiac catheterization and some are corrected by open surgery. (Details of device closure are available under cardiac interventions)
VSD (Ventricular septal defect):
The left and right ventricle are separated by inter-ventricular septum. When there is defect in the inter-ventricular septum it is known as VSD. VSD results in blood abnormally flowing from left to the right ventricle. There are four types of VSD and there are three sizes of VSD (small, moderate and large). The treatment and outcome depends on the type of VSD. Some VSDs close spontaneously while some VSDs need to be closed either by surgery or by devices. (Details of device closure are available under cardiac interventions)
PDA (Patent ductus arteriosus):
Normally in fetal life (inside mother’s womb) the aorta and the pulmonary artery are communicated by the ductus arteriosus. This ductus closes after birth. In case of some children this might remain open abnormally which is called patent ductus arteriosus. All PDAs need to be closed. Small PDAs can be closed by devices while large PDAs need surgery. (Details of device closure are available under cardiac interventions).
Frequently heart defects are combined and complex problems are associated with these septal defects. Those are more complex disorders which I can clarify for a particular patient.
In conclusion : I want you to understand that “A hole in the heart” is not always dangerous, though it signifies heart disease and needs evaluation and treatment.
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