The American Society of Echocardiography (ASE) released a new document describing various imaging strategies for diagnosing a “hole in the heart,” one of the most common types of congenital heart defects. The document, Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions, describes the various defects, the modalities used to evaluate them, and clearly lays out strategies for optimal imaging.