From the name, we might think the term "hole in the heart" is a situation where there is a real punched hole in the heart where blood leaks out into our chest or body cavity.
Holes in the heart are simple congenital heart defects. Congenital heart defects are abnormalities in the heart's structure that are present at birth. These defects change the normal flow of blood through the heart. Some of these defects are very minor and will never cause health problems while some are complicated and can lead to death.
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How The Heart Works...
The human heart has 4 chambers.
- Left atrium
- Right atrium
- Left ventricle
- Right ventricle
The atria are staged side by side and make up the upper chamber while the ventricles are also staged side by side and make up the lower chamber of the heart.
The pumping action of the heart moves in a cycle.
The left atrium receives oxygen-rich (oxygenated) blood from the lungs and pumps it to the left ventricle which then pumps the blood to all other body parts.
The right atrium receives oxygen-poor (deoxygenated) blood from the body and pumps it to the right ventricle which pumps the blood to the lungs for it to become oxygenated again and be received by the left atrium.
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The two sides of the heart (right and left) is separated by an inner wall called the septum. With each heartbeat allowing the pumping action to occur, the septum prevents mixing of the deoxygenated and oxygenated blood present in the two sides of the heart. This is where the hole in the heart comes in.
It is on this septum the hole is found.
- A hole in the septum between the two upper chambers (atria) is called Atrial Septal Defect (ASD).
This abnormality in the heart structure allows oxygenated blood recieved in the left atrium pass into the right atrium that is receiving deoxygenated blood. So, oxygenated blood is pumped into the lungs instead of into other parts of the body.
The flow can also occur otherwise.
- A hole in the septum between the two lower chambers (ventricles) is called Ventricular Septal Defect (VSD).
Also in this case, the oxygenated blood get pumped back to the lungs instead of the body.
These phenomena usually lead to:
- abnormal heart rhythm
- shortness of breath
- tiredness
- cyanosis (bluish discoloration of the skin due to insufficient oxygen in the body system)
and in severe cases - pulmonary hypertension
- stroke
- heart failure
Apart from ASD and VSD, other similar defects include:
A hole affecting blood flow in all four chambers; Complete Atrioventricular Canal Defect (CACD).
Aorta located above the hole of a large VSD, a thickened wall around right ventricle and a stiff pulmonary valve; Tetralogy of Fallot.
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Diagnosis
General diagnosis involves:
- Checking if heart murmur is significant.
- Chest X-ray to determine the shape and size of the heart and the state of the lungs.
- Electrocardiogram to check the electrical activity of the heart.
The only solution to a problematic congenital heart defect is undergoing surgery or sometimes, a series of surgeries.
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Just to add on, the reason why the oxygenated blood from the left ventricles being pumped into the right ventricles instead of the other way around is the pressure provided by pumping action of the left ventricle is much higher than the right. After all the left ventricle needs to ensure they apply sufficient pressure so that blood can travel to a various part of the body. Just, take a look at the left ventricular muscle, much more significant than the right ventricle, isn't it?
Nice article, really simple and easy to understand.
Wow! That's true. Thanks for sharing.
Very educating post. You see while growing up i actually thought that this was a literal hole :)