DEAR DR. GOTT: I’m a 61-year-old male with a 10-year history of heart problems. I’ve had two heart attacks, resulting in partial heart damage, had three stents put in, and a triple bypass operation. On my last visit to my cardiologist, he informed me that I have a hole on the front side of my heart in need of mending with a mesh-type patch. What causes a hole in the heart and might there be risks if I choose not to have the operation? I’m undecided.

DEAR READER: This is one issue that sounds terribly frightening, but may represent a congenital heart defect that has likely been present since birth. If this isn’t the case, your physician may be referring to a “hole in the front of the heart” which isn’t a true hole but rather a aneurysm of the left ventricle due to the damage caused by your heart attacks. For thoroughness’s sake I will discuss both.
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