Ask the Cardiologist: Information on Holes in the Heart

MalinskiDr. Maciej Malinski is on the medical staff at Sherman Hospital. He has been kind enough to answer some frequently asked questions related to maintaining a healthy heart. Look for additional heart information from Dr. Malinski in the coming weeks.

Q: I have a hole in my heart and I’m 50 years old. What test(s) do I need to think about having? -Roxanne

A: When you say you have a “hole” in your heart, that usually means you have abnormal communication between right and left heart chambers. Right heart chambers pump blood to your lungs, and have lower pressures than left heart chambers that receive blood from lungs to pump it to the body.

The pressures in the left side of the heart are higher, so if you have a “hole” in the heart it means there is direct communication between left and right chambers. This also means there is an abnormal direct flow (shunt) of blood from left to right chambers.

If the hole is small, the volume of blood going directly from the left heart chamber to the right is not large, and clinically it is not a significant shunt. If the shunt is significant it can eventually cause heart failure. Common symptoms of heart failure include shortness of breath and retention of fluid (showing as leg swelling). A significant shunt can also cause strokes and arrhythmias. If the shunt is significant, most of the heart failure symptoms would develop by the time you’re between 30 and 40 years old.

Sometimes heart chambers communicate abnormally. The most common abnormal communication between heart chambers is atrial septal defect (ASD), which is an abnormal communication between the upper heart chambers (atria). ASD is the second most common overall congenital heart defect.

It sounds like you’re a healthy 50 year old, Roxanne, so you probably have ASD with a shunt that’s not significant. But in any case, you (and everybody with a heart congenital defect) should see a cardiologist at least once. The best test to confirm the diagnosis and to see if you have any complications is an ultrasound of the heart, which will tell us if further steps need to be taken to remedy your heart condition.

Do you have a question for Dr. Malinski? To submit your question, either post it in the comments section below or email with the subject line “Question for Dr. Malinski.” For more information on heart health, click here to visit Sherman’s Heart and Vascular Center.

This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician.

About Sherman Health

Sherman Health has provided medical care to Northern IL since 1888, and is currently home to a network of over 600 physicians. The Sherman blogs are edited by me, Luke. Questions? Comments? Links? Email address is luke at shermanhealth dot com.
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2 Responses to Ask the Cardiologist: Information on Holes in the Heart

  1. lynn says:

    I have PFO with a lot of symptoms. I am 45 and my symptoms are dizziness, lightheadedness, shortness of breath and zero energy. When I get the hole closed will all these go away? I have migraines as well.

  2. Thanks for the question, Lynn! Dr. Malinski recently answered your inquiry in a blog post titled “Ask the Cardiologist: Will Closing My PFO End My Migraines?” Check it out!

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