Holes in the heart are a type of congenital heart disease. Ventricular septal defect (VSD) and atrial septal defect (ASD) are the two most common congenital defects that may affect an individual. These occur due to structural malformation in the walls of the heart when these are developing at the fetal stage. ASD and VSD can be repaired and closed as soon as they are identified or right after birth. ASD is the hole in the septa that divides the two atrium and VSD refers to the hole in the ventricular walls. The holes allow the reverse flow of blood, thus, facilitating the mixing of pure and impure blood.

• To understand the holes in heart we must briefly understand the working of the heart. The heart works like a pump beating on an average of 100,000 times in a day. It has two sides which are divided by a wall called septum. The right side of the valve pumps blood to the lungs and picks up oxygen. The oxygen-rich blood then returns to the left side of the heart from the lungs and then the left side pumps it to the rest of the body.
• These two sides are divided into 4 chambers having four valves connecting them to various blood vessels. For carrying blood from the body to the heart, veins are responsible while arteries carry the blood away from the heart to be circulated to the body. The atria are two upper chambers that collect blood while ventricles are the two lower chambers pumping the blood to the lungs and other parts of the body.
• The valves act like doors allowing a flow of blood through the next chamber to arteries and then they close to keep the blood from again returning back to the previous chamber from where it came. In a systolic contraction, the ventricles pump blood from the heart and in a diastolic contraction, the ventricles relax to receive blood pumped by the atria. The aortic and pulmonary valves close at the beginning of the diastole to prevent the chances of backflow. Thus, the presence of a hole in the septa may lead to mixing of the blood and interfere with the normal flow of blood circulation in the body.
• An ASD is naturally present when the baby is still a fetus. But the hole closes on its own by the time of birth. However, in some cases, it may persist even after birth. An ASD can be of different types, including sinus venosus atrial septal defect, mixed atrial septal defect, ostium secundum atrial septal defect. A VSD, on the other hand, is usually detected in a baby or in an adult when a doctor observes a heart murmur. Certain tests such as an echocardiogram or electrocardiogram are performed to confirm its presence.

Typically, medications are administered to see whether ASD or VSD closes on its own. In case the defect does not close on its own and the individual continues to experience atrial septal defect symptoms such as breathing difficulties, heart murmurs, shortness of breath, and respiratory infections, then a surgery is recommended. The surgical procedure for atrial septal defect repair and ventricular septal defect treatment are almost the same, except the fact that different parts of the heart are targeted during the surgery.