Diving below 85 feet

[Thresa]

My aunt was telling me that her mother in law died in a scuba diving accident about 8 years ago. She had been diving for 16 years, but had never done any deep dives. On her final dive they went below 85 feet and she had a heart attack. The family was told that she had a genetic defect that was a hole in her heart. They were also told that ¼ of the population unknowingly has the same defect and it never affects people unless they scuba dive below 85 feet. They said that it had nothing to do with age and she had not been overly exerting herself. The only cause was this hole that she had unknowingly had in her heart. Has anyone ever heard of this? I was really surprised to hear that because it seems like a lot of divers go below 85 feet, but you don’t hear of that many (1/4 of those who go below 85 feet) having heart attacks.

 

[MSilvia]

Yeah, a patent foramen ovale (PFO) is a defect in the wall between the upper chambers of the heart.

Check out this DAN article: http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=50

 

[JeffG]

Like most things that are "I heard from someone, who heard from someone....etc etc" there is a grain of truth, but most the details of your story is wrong.

Do a search on PFO's

 

[wedivebc]

My aunt was telling me that her mother in law died in a scuba diving accident about 8 years ago. She had been diving for 16 years, but had never done any deep dives. On her final dive they went below 85 feet and she had a heart attack. The family was told that she had a genetic defect that was a hole in her heart. They were also told that ¼ of the population unknowingly has the same defect and it never affects people unless they scuba dive below 85 feet. They said that it had nothing to do with age and she had not been overly exerting herself. The only cause was this hole that she had unknowingly had in her heart. Has anyone ever heard of this? I was really surprised to hear that because it seems like a lot of divers go below 85 feet, but you don’t hear of that many (1/4 of those who go below 85 feet) having heart attacks.

This defect is well known. It does not cause heart failure though. It causes small bubbles which normally are passed harmlessly to the lungs where they are exhaled to pass though to the arterial blood supply which can then lodge in places where they can cause severe damage. Since a heart attack is loss of blood flow to a portion of the heart, it would seem that is where this bubble unfortunately lodged. It could have just as easily landed in the brain, causing a stroke.
The depth involved is not really an issue since the bubbles can form during any dive and although are more likely with greater depth it was only a limited factor.

 

[Web Monkey]

My aunt was telling me that her mother in law died in a scuba diving accident about 8 years ago. She had been diving for 16 years, but had never done any deep dives. On her final dive they went below 85 feet and she had a heart attack. The family was told that she had a genetic defect that was a hole in her heart. They were also told that ¼ of the population unknowingly has the same defect and it never affects people unless they scuba dive below 85 feet. They said that it had nothing to do with age and she had not been overly exerting herself. The only cause was this hole that she had unknowingly had in her heart. Has anyone ever heard of this? I was really surprised to hear that because it seems like a lot of divers go below 85 feet, but you don’t hear of that many (1/4 of those who go below 85 feet) having heart attacks.

As noteed by others, it's called a PFO.

This is one thing you don't need to spend another 10 minutes worrying about. You can be tested using a painless, non-invasive ultrasound test, and find out if you have it or not.

If you don't have one, you can relax and enjoy diving. If you do have one, you can check with Diver's Alert Network for a referral to a SCUBA-qualified cardiologist who can discuss options with you (both surgical and/or modified dive parameters).

It's good to know your relative's medical history. Their problems give you advance notice of things you can watch out for in yourself (before they cause problems).

Terry

 

[LavaSurfer]

Interesting, or scary, is the fact that PFO's can cause problems whether you dive or not. One of my good friends just had a major stroke and the cause of the clot was a PFO that he was unaware of until the medical exam following the stroke.

Luckily he is fine and shows no long term effects. The doctors are scheduling surgery to repair the PFO.

He is 33, runs 5 miles a day, eats good food and is a health nut!

 

[Dr. Doug Ebersole]

First of all, I am a cardiologist with an interest in diving medicine. Here is my 2 cents. It is true that approximately 25% of the population has a PFO and that the vast majority of them has no consequence from it at all.

However, there is absolutely no truth to the statement that "it never affects people unless they scuba dive below 85 feet". It is extremely unlikely that the PFO had anything to do with your relative's death. The problems with PFO are right to left shunting across the atrial septum from the pulmonary circuit to the systemic circuit. For landlubbers the problem is small (or large) clots that would normally be "filtered" by the lungs but now make it into the systemic circulation and cause strokes. PFOs are routinely sought in what is termed cryptogenic stroke -- stroke with no other obvious cause found.

For divers, the problem is not clots but small bubbles upon ascent that can cross the atrial septum and cause arterial gas embolization. The greater the nitrogen loading (deeper dives, longer dives, decompression diving, commercial diving, etc) the more the theoretical likelihood of bubble formation that could cause problems, both with usual DCS and with right-to-left shunting of bubbles.

Granted I have no details in your relative's death, but it is far more likely that she simply had a "run of the mill" heart attack from atherosclerotic coronary artery disease. It could have happened in her sleep, on driving on the Interstate, or playing golf. However, since it happened underwater it gets labeled a scuba diving fatality.

If you have any details of the event, her history, the autopsy, etc feel free to PM me. I will gladly discuss things with you in more detail if that will be helpful in anyway to you or other family members.

Sorry for your loss.

Doug

 

[alpaj]

Damn Doug way to steal my thunder. I started researaching it and everything

 

[alpaj]

Though on second thought I was wondering how a right-to-left atrial septum shunt differs from a left to right shunt. Are L-to-R shunts in the ventricular septa? Is it not as much of a problem because of the higher pressure in the left ventricle? And do you know what percentage of people have atrial vs ventricular shunts? Just wondering thanks.

 

[LavaSurfer]

If you have any details of the event, her history, the autopsy, etc feel free to PM me. I will gladly discuss things with you in more detail if that will be helpful in anyway to you or other family members.

Doug

Truly a class act, My hat is off to you!