Monday, May 17, 2010

Medical Mondays: Hole Hearted

Happy Monday to you all. This week's fictional medical question comes from Christina Lee.

Can a child die from a hole in the heart (nowadays, with the latest technology available) and if so, how? Bacterial infection etc.?

A "hole in the heart" usually refers to a defect of the wall between the left and right chambers. Between the atria, or chambers that accept blood into the heart, patent foramen ovale (PFO) and atrial septal defect (ASD) are the common defects. Between the ventricles, or larger pumping chambers, a "hole" would cause a VSD, or ventricular septal defect.

Illustrations are from NMT Medical.

A Patent Foramen Ovale, or PFO occurs when a natural opening in the heart (necessary for the growing fetus) doesn't close after birth. About 25% of adults and kids have a PFO. Yes! That's one in four of you guys! But the good news is, this rarely causes problems for children. In adults who get strokes for unknown reasons, the cause can sometimes be a PFO, where blood clots escape to the "other" side of the circulatory system and cause strokes.

An Atrial Septal Defect, or ASD is a common heart malformation in babies. In moderate to large holes, they can cause problems with shunting (blood traveling the wrong direction). But nowadays, these are easily repaired.

And finally, a Ventricular Septal Defect or VSD is often managed with medications but can be surgically repaired if causing serious symptoms of shortness of breath and heart failure.

So for Christina's question, can someone still die from these, in this day and age? Without repair, many with serious ASD and VSDs can have heart problems as kids and later in life. There are plenty of circumstances when kids can't get adequate medical care and these problems could potentially become deadly. With repair, they are still at risk for infection of the surgical site (bacterial endocarditis), but most people get antibiotics to prevent this (such as before dental work). And PFOs usually don't cause trouble at all in kids.

The bottom line? A hole in your heart is often not as deadly as we think it might be. But they make for good pop songs (cue cheesy Extreme song from 1991). Hope this answers your question. If you have more, feel free to email me!

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice!

If you've got a medical question, let me know! Post below or email me at

I will usually answer your question by email within a day or two, but post later so you don't have to wait a long time to get back to your WIP. All I ask in return is that you become a follower of my blog and post a link on your blog when I post. Easy peasy.

Also, don't forget to check out Mental Health Mondays at Laura's Blog!

And don't forget to enter my 150 Follower Giveaway!


Vicki Rocho said...

Wow. I didn't know that. Very informative!

Unknown said...

Great post!

There's been a number if cases in the last few years, in the States and in Canada, in which teenage boys have died during an athletic event due to an undiagnosed heart problem (though I don't think it had to do with a hole in the heart). These boys were all athletes, and in peak physical shape. A hole in the heart is what killed one of the characters in 20 Boy Summer, which I reviewed last week.

Candyland said...

Someone should write a song about the hole in their heart, literally. Though, probably not as romantic:/

Tina Laurel Lee said...

Appreciated as always. This is an awesome service you provide.

Paul C said...

So interesting and well explained with graphics. I suppose a hole in the heart is more serious than inefficient valves?

Christina Lee said...

YAY!!!! Thank you for answering my question! I have a character in my book who has VSD, and I feel good that I "mostly" got it right!!! THANKS again!

Anonymous said...

My daughter was born needing a ventrical switch and a patch over a hole in her heart. They let us bring her home because the real extent of the problem wasn't known, only that she had a pronounced "murmur."

As it was, we spent 6 weeks at home with no real sense of urgency. We even rescheduled the initial cardiologist appointment.

She saw the cardiologist on a Friday afternoon by the following Monday morning she was in surgery!

Now we know how much of a risk she was at during those first 6 weeks of her life. The doctors were surprised that she wasn't born "blue" her problems were so severe.

We took a big chance without even knowing it - she could have died during those weeks at home.

Lydia Kang said...

Miss V and Tina--glad you enjoyed it!

Stina--I'll have to check that out. Haven't heard of that one!

Candyland--you should hear this Extreme song. It's kinda horrible, IMHO.

Paul C--inefficient valves come in all ranges of seriousness, so it depends!

Christina--you're very welcome! I'm so glad I could be helpful!

Jaydee Morgan said...

I love learning about this stuff - and you're Monday posts are always so informative and interesting. Thanks for sharing :)

Janet Johnson said...

Great information! My dad actually had one that went undetected till he was 50ish. Caused a mini-stroke. But they did surgery, and all is well.

Love your posts, as always!

Lydia Kang said...

Dear Anonymous,
Often when the child is really ill, the "blue" sign is very pronounced. Strangely, the "hole" may have been the reason for why she fooled the doctors for so long. The mixing of oxygenated blood and non-oxygenated blood via the hole may have allowed her to survive without detection for so long.

I know a child who needed a ventricular switch operation (actually it was tranposition of the great arteries and he had an arterial switch operation), but had no hole and was born blue, and the doctors had to take him to the cath lab and physically tear a hole in the heart (make an artificial ASD) in order for him to survive until he could get to surgery.

He had a happy ending, and I'm glad that your little one did too!

Unknown said...

Wow! I just need to visit your blog everday to learn something new! This was very informative and I learned a ton! Thanks for sharing!

Anonymous said...

Great post, Lydia!! Nice pics. ;)

Unknown said...

Your medical posts are so fascinating! Thanks, Lydia!

Crystal Cook said...

Wow, that is very interesting. And I really like your idea of answering a medical question. You are so multi talented!

Tricia J. O'Brien said...

Medical Mondays is brilliant. Thanks for doing these.

Diane said...

Amazing how we are made and so many things that could go "wrong". Have a great week. :O)

Southpaw said...

I agree with Tricia Medical Mondays are brilliant!

Susan Fields said...

That is so cool! I didn't realize you answer medical questions - what a great thing for us writers (who have questions about everything!) Thanks for doing this. And your explanation was very interesting - thanks!

Emily Ann Benedict said...

One of my cousins had this happen to her, but if I recall correctly all was well after a surgery when she was 4. She never really sufferend any serious symptoms and rebounded really quickly. Pretty amazing what we can do today. :)

Tahereh said...

wow, lydia, another AWESOME post. this is SO helpful..

Jackee said...

Great summary and so succinct and understandable! Thanks for this!

And thanks for doing the great May Challenge with me--it means a lot. :o)

Lindsay said...

I've said it before and I'll say it again...I love learning all these new things on a monday. :)

Stephanie McGee said...

Interesting. I was born with a heart murmur. They kept me in the hospital for about a week. By the time my original due date came around (I was a couple weeks early) it had closed up on its own. Glad it wasn't one of these more serious issues.

bard said...

But can a man die from a hole in his soul?

Amanda Borenstadt said...

LOL, Bard, you're such a poet.

Lydia. Great info. I was checked a few years ago because of a murmur my doctor was worried about. Turns out I have two holes (one of which they knew about when I was a baby and though would close up) plus leaky valves and my cardiologist said I'll live a long and normal life and not to worry about it. I was shocked.

Lydia Kang said...

Hey Amanda!
Yes, stuff like that is way more common than people realize. Good to know that you're still considered healthy though!

Bard--It depends. If you crawl into that hole, where will it take you?

Hey Stephanie! It's so common, see? I'm glad it all worked out!

Emily, Isn't it amazing what can be done these days, and on such little kids?

Hey Lindsay! I'm glad you liked it. I'm trying not to bore people, ha ha.

Hey Jackee! I hope I can keep up with the challenge. I'm going to try!

Hi Tahera!Glad you liked it!

Hi Susan, Yep, I figured it was a way to help out my fellow writers without charging for a fictional clinic visit...

Southpaw, Tricia, and Diane--thanks for stopping by!

Hi Crystal! Ummm, multi-talented? I can multitask, is that the same thing?

Hey Nicole, thanks for stopping by! Glad you liked it!

Hey Laura! I loved your post too!

Hi Jen! I'm glad you learned something! I learn something on your blogs too, it goes both ways!

Hey Janet, Yep, that's what happens sometimes. I'm glad the surgery went well!

Hi Jaydee! I love your avatar, btw. Thanks for visiting!

Kimberly Franklin said...

Very informative. You're so sweet for sharing your expertise with us. :)

I hope you have a great day!!

Theresa Milstein said...

I didn't know that either.

My husband is a scientist. At the conference I met two other women who are married to scientists. But I didn't run into anyone with a medical background who is also a writer.

Kathi Oram Peterson said...

I had a PFO closure five years ago. Yep, I had a hole in my heart since childhood. They found it when I had a stroke. It wasn't a usual stroke with the numbness on one side. I became confused, so much so that I had no memory of the conversation I had with my sister at the time of the stroke. I'm so grateful it wasn't worse and with the closure I hopefully won't have any more. :0)

Jemi Fraser said...

I love these Monday posts! I had a student once with this condition but I don't remember much about it.

Kenda Turner said...

Lydia--wow, interesting stuff:-) I'm going to enjoy following your blog.

Thanks for the follow to mine!

Lydia Kang said...

Hey Kimberly,
Thanks for dropping by! Glad you found it informative.

Hi Kathy,
Wow, that sounded absolutely frightening. I'm so glad the closure went well and that you are healthy!

Hi Jemi, Glad you liked it! Thanks for commenting!

Welcome Kenda! I'm glad to be following you too!

Talli Roland said...

Interesting question and great answer. As always, Lydia, I love your Medical Mondays!

bard said...

"Bard--It depends. If you crawl into that hole, where will it take you?"


Linda said...

I love learning about this kind of stuff. Very informative article

MeganRebekah said...

My brother's puppy died from "a hole in his heart" due to over breeding at the puppy mill. It was so sad.

Thanks for sharing this great post!

Shannon said...


I love your Medical Monday posts. I *always* learn something new.

Thank you so much!

Anonymous said...

I love for Medical Monday posts! So interesting to learn about all these diseases/medical problems. And this came right after an intense review of the cardiovascular system -- very aptly timed. :D

DEZMOND said...

Hey, lovely Lydia, thanks for visiting my HOLLYWOOD SPY headquarters :) I love how you find the time to inform people about medical issues here at your blog ;)

kanishk said...

Someone should write a song about the hole in their heart, literally. Though, probably not as romantic:/
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Unknown said...

I love learning about this stuff - and you're Monday posts are always so informative and interesting. Thanks for sharing :)

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