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What’s the Difference Between a Leaky Heart and Having a Hole in Your Heart?

Learn the symptoms of both heart issues and how they’re treated

An image of the heart illustrates article on the difference between leaky heart and hole in heart conditions.

Learn the symptoms of both heart issues and how they’re treated

The terms “leaky heart” and “hole in the heart” both refer to health conditions that involve the heart, but while they sound similar, they are unrelated problems.

The difference between leaky heart and having a hole in the heart is the part of the heart that is affected.

What is a leaky heart?

The heart has four valves, each of which has flaps that open to let blood flow through as it travels through the heart. The flaps then close to prevent the blood from flowing back to the heart. A valve leaks when a flap does not close properly, allowing blood to leak backward and putting strain on the heart. This is also known as valve regurgitation.

Any of the valves may become leaky, but the mitral valve is the most common type of heart valve disease. Heart valves may become leaky due to high blood pressure, infection of the valve (endocarditis), when the heart weakens for other reasons, or a structural defect in the valve.

Depending on how much blood leaks through, a leaky heart valve may or may not cause symptoms. Slight or even moderate cases may have no symptoms, and people may not even be aware they have a leak. Severe leaks, however, may significantly affect blood flow and cause symptoms, such as shortness of breath, swelling in the legs or other parts of the body. Other leaky heart valve symptoms may include lightheadedness, fatigue, and a rapid heartbeat as the heart works harder to pump enough blood. This can raise the risk of heart failure, heart attack and stroke.

Leaky heart valve treatments

Many people with leaky heart valves may just require observation over time to monitor changes in their condition. If treatment is needed, it may include medications to manage blood pressure or treat symptoms. Surgery may be recommended to repair or replace the leaky valve.

“At Scripps, we treat many cases of mitral valve regurgitation with a minimally invasive procedure using the MitraClip, which is an FDA-approved device that allows us to repair heart valves without doing open heart surgery,” says Matthew Price, MD, an interventional cardiologist at Scripps Clinic John R. Anderson V Medical Pavilion in La Jolla.

The MitraClip device fixes valve leaks by clipping together the sections of the valve that are not closing correctly. The interventional cardiologist inserts a thin tube called a catheter into a leg vein, guides it up to the heart, then guides the device through the catheter to the mitral valve.

Leaky heart valves also may be repaired or replaced with traditional open heart surgery. The patient’s cardiac care team will determine the most appropriate approach.

What is a hole in the heart?

A hole in the heart is a condition where a hole exists in the wall (septum) between the chambers of the heart. They are usually congenital birth defects, which means they are present at birth. During pregnancy, a baby’s septum normally has several openings that naturally close before or shortly after birth. If a hole does not close on its own, it is called a septal defect.

The most common types of heart holes are called septal defects. An atrial septal defect (ASD) is a hole in the septum between the two upper chambers of the heart; a ventricular septal defect (VSD) is a hole in the septum between the two lower chambers. Normally, the left side of the heart pumps blood to the body, and the right side pumps blood to the lungs. With ASD or VSD, blood flows through the hole back to the lungs. Increased blood flow through the lungs can damage blood vessels in the lungs over time, which can lead to high blood pressure and heart failure in adulthood.

Hole in the heart treatments

Small septal defects may go unnoticed if they cause no problems. Larger holes usually cause symptoms during the first few weeks of a child’s life and may require repair to prevent complications down the road.

“In most cases, we can use a catheter to place a plug into the hole to block it,” says Dr. Price. “Occasionally, some cases may require surgery to close the hole. With both procedures, the results are usually very successful.”