The Facts About Holes in the Heart & How They’re Treated

Posted: Thursday, July 15, 2021

The very idea of a hole in the heart may sound alarming, but it’s surprisingly common. On top of that, some people may have a hole in their heart and not even realize it.

In fact, the American Heart Association estimates that about a quarter of the American population has some type of hole in the heart. That’s around 82 million people!

If someone has a hole in their heart, it falls into one of two most common categories: patent foramen ovale (PFO) or an atrial septal defect (ASD).

While these holes may be present, they’re often left undiagnosed because they don’t typically cause any issues or symptoms. But that isn’t always the case. Larger holes in the heart can increase your risk of serious health issues and may require treatment.


Pranav Kansara, MD, MS, FACC, FSCAI, interventional cardiologist and medical director of NGHS’ Structural Heart Program, shares key facts about these common structural heart conditions:

A Look at Patent Foramen Ovale (PFO)

This type of hole in the heart is something that occurs in infancy. As a baby in utero, there is a hole in the heart tissue that separates the left and right chambers, also known as the interatrial septum. This hole is called a foramen ovale and it exists to allow blood to bypass the fetal lungs since they don’t work until exposed to air. However, once born, this hole naturally closes at birth and if it doesn’t, the hole that continues to exist is known as a PFO.

This type of hole is often small in size, and, in most cases, the only effect of a PFO is blood leaking between the right and left chambers. Unless a PFO is detected during childhood, it may go undetected for years, until a person experiences conditions like migraine or stroke that require careful investigation and diagnosis.

Most PFOs require minimal treatment or none at all, they may be left open. In some cases, treatment may be recommended using structural heart intervention, where a closure device is deployed using minimally-invasive techniques.

A Look at Atrial Septal Defect (ASD)

An ASD, or atrial septal defect, is also a hole in the septum between the left and right chambers of the heart. But unlike a PFO, which occurs when a naturally forming hole doesn’t close after birth, an ASD is a type of congenital heart defect that occurs when the septum doesn’t form normally.

In many cases, small ASDs cause very little disruption to the function of the heart and lungs. Larger defects or holes may cause symptoms such as a poor appetite, fatigue, shortness of breath or lung infections.

When the ASD is larger, a heart murmur may be detected and treatment may be recommended to alleviate the risk of permanent damage to the heart chambers from needing to work harder.

Similar to a PFO, treatment for an ASD typically includes the deployment of closure device that’s done through a minimally-invasive structural heart procedure. These procedures are performed by highly-trained interventional cardiologists and patients are evaluated in collaboration with cardiothoracic surgeons.

Expertise in Structural Heart Care

When there are conditions affecting the structure of the heart, like PFO or ASD, it’s essential to receive highly-specialized care that starts with a precise diagnosis and innovative treatment options. Whether you have a condition impacting the valves of the heart or a hole, our team of expert interventional cardiologists and renowned cardiothoracic surgeons offer the most advanced, minimally-invasive treatments available.