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What Does A Hole In Heart Indicate?

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Posted on Fri, 30 May 2014
Question: Can you please explain this to me... In 2009 I had a hole in mu heart closed by key hole surgery... Attached is my echogram donw in 2011..
doctor
Answered by Dr. Sukhvinder Singh (4 hours later)
Brief Answer:
please see details.

Detailed Answer:
Dear madam
The report says that there was a hole in your heart at atrial level which was closed with the help of a device. This device is placed without any surgery through blood vessel in your groin. It is working well and there is no residual hole now.
Your right sided heart chambers are still enlarge which is a feature of this kind of holes. But they are functioning well. There are normal pressures on right side. The size of chambers usually regress over a period of time in such cases.
All other mentioned parameters are within normal limits.
Hope this helps.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (6 hours later)
So where is says "Trivial rik pericardial fluid noted posteriorly" does this mean i have fliud around my hert somewhere? And its says mildly enlarged heart can this be serous?
doctor
Answered by Dr. Sukhvinder Singh (8 hours later)
Brief Answer:
please see below

Detailed Answer:
Respected Ma'm
The trivial rim of pericardial fluid is most likely to be a normal variant as we normally have 15-50 ml of fluid in the sac around our heart.
The mildly enlarge right side of heart has already been discussed above. This will require a comparison with your older echocardiogram and follow-up echocardiogram (duration of which will be best suggested by your cardiac physician who was involved in device implantation). In the given clinical scenario, this mild dilatation does not seem to be serious immediately.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (18 minutes later)
Thank you. I am no longer under a cardiac doctor as i was discharged shortly after this echogram. Within the last 2 months i have been expericing a low heart rate of 50 - 60 bmp while at rest... As soon as i move my heart rate will rise to about 62 or 63 when i stand it beats aroubd 85.... I have experices on the odd occasion while standing in 1 spot still a heart rate of 60. I have been back and forth to the doctor my blood pressure is 125/70 or sometimes 125/68 ecg was normal... But i am worried as iv never expericed a heart rate of less then 60 before (well that i know of) i never really checked it before...
doctor
Answered by Dr. Sukhvinder Singh (14 minutes later)
Brief Answer:
please see details.

Detailed Answer:
Respected Ma'm
A heart rate between 50-60 beats per minute may be perfectly normal, if there are no symptoms. If you do not feel any giddiness, transient lack of alertness or blackout associated with this rate, it is likely to be normal. Our heart rate is determined by level of activity or stress (physical and mental) and many other influences and is variable. We consider this much rate as low, only if there are symptoms associated with it.
The best way is to get a simple elctrocardiogram (ECG) at time of low heart rate and ascertain the rhythm. Since your ECG is normal too, it is likely to be all normal.
Your blood pressure readings are normal too.
Since you are not under the care of cardiologist, your primary physician can clinically examine and compare reports of 2009 and 2011 and decide if you really need another ECHO or not. It also depends upon the local practice too.
Hope this clarifies the doubt.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (29 minutes later)
Thank you it doea help.. I am 31 years of age and it worries me to think one side of my heart is larger then the other i expected this to be something that would be checked yearly ? The slow heart rate is only when i am relaxed and resting so any movement it will spike to just over 60. So everytime a ecg is done my heart rate is normal. Should i worry that my large heart could be the cause... And can you tell me from looking at the echo test i sent... Was the overall result poor satisfactory good very good excellent. Thank you very much for your time
doctor
Answered by Dr. Sukhvinder Singh (1 hour later)
Brief Answer:
please see below.

Detailed Answer:
Respected Ma'm
It is entirely normal to be heart to be low and then to increase on activity. If there are no symptoms associated with this low heart rate , you need not to worry about it.
The enlargement of right side of heart is a normal thing for ASD (the hole you had) and it regresses over a period of time after surgery or device closure. Moreover the function and pressure of right side of heart are normal. So it is reassuring.
The follow up schedule for such device varies from center to center. However you must visit your cardiologist if you have any trouble.
Overall your ECHO report seems satisfactory provided you have no symptoms. Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (10 minutes later)
Well the problem is i have been having sympotms maybe not to do with my low heart rate but for about 2 years now i have been back and forth to the doctors office with light headedness.. I have told the doctor that i suffer from episode where i feel my body is weak and i am not steady on my feet. Sometimes out of the blue while at work i feel light headed and need to sit when i feel my pulse it is beating at about 85... I have been feeling this way for the last 2 years on and off and recently the fluuerting of the heart happens now and again... One minute i feel fine the next minute i have to
Sit down... Full blood count seems to be normal this was last check in Feb of this year.. Im
Probably scared the most of having a heart attacked or my heart failing...
doctor
Answered by Dr. Sukhvinder Singh (9 minutes later)
Brief Answer:
please see details

Detailed Answer:
Respected Ma'm
If you had device closure after the age of 25 years (accidentally your age has been mentioned as 17 on this page), then some of the features of ASD (atrial septal defect) may persist like fluttering of heart, mild enlargement of right side of heart etc. At times the very fast fluttering may be associated with lightheadedness.
lightheadedness can be a feature of low heart rate also. To decide if the heart rate related issues (fluttering or slowing) are really responsible for your lightheadedness, we advise "24 hour holter monitoring" or "extended loop recorders" which can record your ECG for longer periods. If you develop any symptom or lightheadedness during the monitoring period, we will be able to ascertain the heart rhythm at that time and can correlate.
There can be other causes of the lightheadedness especially related to fall in blood pressure on standing which can be checked easily by your GP.
Hope this helps. Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (11 minutes later)
The hole in heart was repaired at the age of 26 after having 2 children... I am on the waiting list for the holter... The doctor referred me to the cardiologiat last year but i was declined due to all tests being normal... I dont really understand why i was taken off the list if my heart is only working at a satisfactory rate (going by the echo) in this time I have to put up with all the light headness thinking I could possibly have a heart attack at anytime or heart failure... Besides the right side of heart being mildy enlarged did the echo results show any other issues? Please
doctor
Answered by Dr. Sukhvinder Singh (7 minutes later)
Brief Answer:
please see details

Detailed Answer:
Respected Ma'm
1. The ECHO report does not suggest any dysfunction of your heart chambers, hence no suggestion of heart failure. Does not seem like, that you will progress to heart failure , if we consider your ECHO report.
2. Heart attack is an entirely different disease; not related to your current problem. A female at age of 31 who does not smoke, does not have diabetes and is not on steroid therapy for certain diseases (collagen vascular diseases) is highly unlikely to have heart attack.
3. There are no issues in your report beside this mild right sided chamber enlargement.
4. "The reports are not good/ satisfactory or excellent; it is the patient". So do not go by words, if the physician who examines you is satisfied, you need not to worry.
sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (38 hours later)
Thank you for you answer:) since yeaterday I have been needing to take contant deep breaths, it feels as though i need.. This morning upon waking my heart rate was around the 52 mark and my breathing was all out of sync this was while lying in bed on my stomah then on my back i never felt short of breath just my breathing was differnt or out of time... I realised the time abd shot up out of bed my heart beat raced up to about 100 while taking a shower is was around 85 i then had to make my bed and carry a large matress from one room to another upon doing this my heart was racing... I walked into the lounge sat down leant of felt a skipped beat and again my heart beat had slowed to about 56 then 2 minutes later it was 62.. I did not feel funny just got a wee anxious is this normal.? I an at work now heart rate is normal but i am still continuosly having to take deep breathes
doctor
Answered by Dr. Sukhvinder Singh (5 hours later)
Brief Answer:
please See your GP

Detailed Answer:
Respected Ma'm
For being pathological (abnormal) the awareness of breathing should be out of proportion to given stimulus or circumstances. If anyone else who is watching you can make out that you are out of breath? If not so then it is possibly fine. The rate at which you are breathing (breaths per minute) will also increase if you are really out of breath. If this requirement for deep breath was not there when you slept, then again, it is likely to be normal.
Your ECHO report does not suggest anything which can make you out of breath due to a heart related issue. However it does not rule out non-cardiac issues.
The variations in heart rate are seemingly normal. Since you are able to achieve heart rates of 52 and 56, the likelihood of this shortness of breath to be pathological are remote.
There seems to be an element of anxiety creeping into your complaints.
Please see your GP and get examined. A simple examination will rule out any problematic issue.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sukhvinder Singh (1 hour later)
Please be aware that my echo was done in august 2011? So this was done nearly 3 years ago.... Please tell me having a slow resting heart rate in the morning of about 50 - 60 but throughout the day it is normal well as soon as i walk to work it pika up... But throughout the day it is Around 72 - 90 is this ok? Would you say i have severe bradycardia from what i have described to you above .
doctor
Answered by Dr. Sukhvinder Singh (14 minutes later)
Brief Answer:
please see below

Detailed Answer:
Respected madam
I can provide opinion only on information provided by you.

If you wish to know the current status, you have to provide me with fresh reports. You can consider going back to the treating doctor and discuss about it. If needed the echo may be repeated.

As far as the pulse rate is concerned, no it is not severe bradycardia.

Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sukhvinder Singh (1 hour later)
I have only had a ecg 3 weeks ago which the doctora said was text book perfect... My last blood tests done were in january of this year which was a full blood count again they said perfect... Besides having low iron and my blood oxygen was a little low... Which they said would be because of the low iron levels... The slow heart rate of 50 - 60 i have only noticed last month this was only because i tool my pulse.. Since then i have been to the doctors one fortnight because of the slow heart rate... As i worry about it alot... The doctor has listened to my heart rate and said it nice and strong.. The cardiologist said because the tests are normal he does not see the need to see me. Like i said in a previous message was my concern for heart failer because of my sometimes slow heart rate? Would you call it mild bradycardia?
doctor
Answered by Dr. Sukhvinder Singh (2 hours later)
Brief Answer:
Please see details

Detailed Answer:
Respected Madam
1. The pulse rate of 50-60 beats per minute is ideal for most circumstances. Previously a rate lower than 60 bpm was considered bradycardia but now most of the authorities agree that rate less than 50 bpm should be considered bradycardia. Even that rate (say 48 bpm) may be normal for a given individual especially athletes.
2. I do not understand that how are you correlating your low heart rate with heart failure. In heart failure the heart rate actually increases. Moreover this much of heart rate (50-60 bpm) will never cause heart failure on its own.
3. The predictor of heart failure would be the ventricular function on ECHO rather than heart rate, which are normal in your last ECHO.
4. You should not worry about a heart rate which is in range of 0-60 and increases as your body demands more. This variability of heart rate with activity is a sign of health rather than disease. I would be more worried if you are not able to increase your heart rate with activity.
Hope this clarifies your doubts. Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sukhvinder Singh (20 hours later)
Thank you for your answer. I went to the doctor today about my constant need to take deep breaths it is like i have to fill my lungs with air.. I can talk a 12 word sentance fine and this is worrying me as i heard brethlessness is attachedto heart problems... I can do normal activity but do feel the need to take a deep breath...
doctor
Answered by Dr. Sukhvinder Singh (6 hours later)
Brief Answer:
please see below.

Detailed Answer:
Respected madam
As I suggested you earlier that there is a difference in being breathless and need to take deep breath intermittently. If your doctor could find out any abnormality? If you are not able to sleep properly? If your breath rate is increased? If answers to all of above is NO, then likelihood of this being serious is low.
Yes, breathlessness is a symptom of heart failure. But it should be true breathlessness,
which in your case is doubtful historically.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (7 minutes later)
My breathing is normal, i am able to walk up a flight of stair and walk about but I have to take a deep breath as though i need to fill my lungs...
doctor
Answered by Dr. Sukhvinder Singh (5 minutes later)
Brief Answer:
please see details

Detailed Answer:
Respected madam
Then it is not likely to be serious as your breathlessness should increase on using stairs. It may be a heightened awareness of breathing. Especially, if it does not increases on activity and during sleep.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (36 hours later)
Hello last night i was admitted to hospital due to fast heart rate, My deep breathing became more regular... I was let out 6 hours later this way my ecg while my heart was fast... The doctor said something to me about my sinus rythem being normal so that was good.. My TSH results were supressed but my T3 and T4 were normal...
doctor
Answered by Dr. Sukhvinder Singh (9 hours later)
Brief Answer:
Please see below

Detailed Answer:
Respected Ma'm
The ECG shows Sinus tachycardia at rate of 123 bpm. This means that the rhythm of your heart is faster than normal but is originating from correct place. Hence there is no rhythm disorder. We normally look for a cause of increased rate in such cases like hyperthyroidism, anxiety, stress , anemia, fever , drugs, lung diseases etc. Since your TSH is suppressed I would like you to see an internist of endocrinologist for further evaluation.
This also clarifies your doubt about your slow heart rate being an indicator towards heart failure, which I clarified earlier in detail.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

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What Does A Hole In Heart Indicate?

Brief Answer: please see details. Detailed Answer: Dear madam The report says that there was a hole in your heart at atrial level which was closed with the help of a device. This device is placed without any surgery through blood vessel in your groin. It is working well and there is no residual hole now. Your right sided heart chambers are still enlarge which is a feature of this kind of holes. But they are functioning well. There are normal pressures on right side. The size of chambers usually regress over a period of time in such cases. All other mentioned parameters are within normal limits. Hope this helps. Sincerely Sukhvinder