Suggest Treatment For A Hole In The Heart

Hello, my 47 year old boyfriend said the doctor found a hole in his heart that is one eighth in size. His doctor recommened he see a radiologist for x-rays and a MRI of his heart because of years of very high, uncontrolled blood pressure. On the day of the appointment he was short of breath, weak, sweating, and his blood sugar dropped. He is also a type 2 diabetic. His doctor told him that surgery might be needed depending on the MRI results. My boyfriend is also a recovery addict of cocaine and heroin. Do you think the drugs played any role in this or made the hole become bigger? Is a hole of that size considered big? Does he have a higher risk of heart attack or heart failure? And do you think surgury is needed and if so, what kind? Lastly, why was this detected now, so late in life? Thank- you for your response.