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Hole in the heart

Q: I have VSD problem and have a 4mm hole in the heart. I am now 30 years old. I want to know what type of precautions we should take. If the hole increases what is the remedy? or any other suggestion or guidance, please let me know.

A:Ideally every hole in the heart should be surgically closed because of two reasons. 1) The hole in heart can lead to infection (infective endocarditis) in a small subset of patients and which could be a serious matter. 2) Clot from the right side of the heart can travel in to the left side and produce, what we medically call paradoxical embolism, which again is a serious problem. However, if for some reason or in your own wisdom, you do not want the hole in the heart to be closed, then the only precaution that you could take is that every infection in the body, specially upper respiratory infection like common colds, cough and sore throat, should be adequately treated by competent doctor. Apart from that, I do not think you can take any precautions at your level what so ever. The hole is very unlikely to increase in size and it tends to remain stationary but even a small hole can create serious complications as I have mentioned earlier. Therefore, I would very sincerely advise you to consider operation for closure of this hole in heart which is a very safe operation and would make you 100% medically fit.

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