Hole in the Heart: What Happens Next?

Q.I am 28 years of age and female. Today I had a 'Bubble Study' test which has confirmed a hole in my heart. I didn't see the specialist today, as they are waiting for all my test results before my next appt, (I had the works today!).

I heard them mention a patch when they had completed the test, but am unsure as to whether this means I am probably going to require surgery. I know I should wait to speak to my specialist, but I'm obviously a little shocked to find something wrong, and wondering what to expect now?

A.

It is actually not that uncommon for adults to be diagnosed with a hole in the heart. The condition is a type of congenital heart disease – so you have had this from birth – and it must be a very small hole as you have reached the age of 28 without it being detected. Similar holes have been diagnosed in people of 80!

Small holes in the heart usually occur in the septum between the two atria, the upper, smaller chambers of the heart. This is where the hole is in all our hearts during the time we are growing in our mother’s uterus. The circulation in a growing baby comes from the umbilical cord and through the heart in a completely different way to normal post-birth circulation. In most babies, the circulation re-routes at birth and the hole closes up. In some children, the hole remains open, and these babies have to have surgery to correct the problem quite quickly. In others, and you probably fall into this category, the hole closes up but leaves a tiny hole still there. This can go undetected until well into adulthood.

It is a shame that the medical team could not discuss the implications of your test with you on the day, having told you that the hole was definitely there. I hope that you can arrange to see them soon as this will put your mind at rest about the course of treatment you might need.

It may be that you don’t need any treatment. It depends on how large the hole is and whether it is causing you any problems. If you have been feeling unwell, and that was the reason for the tests in the first place, it is good that the problem has been identified. If you do need treatment, it may be surgery, or it may not. Patches to close holes in the heart can be inserted in a less invasive procedure in which the instruments are guided to the heart through the blood vessels – in a similar way to balloon angioplasty procedures. If you are feeling fine, there is a very good chance that you may be monitored but no treatment will be required.

Try to get an early appointment to find out what is going to happen in your case but try not to worry in the meantime.

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