westonpointer:
Hi everyone,
I am planning a dive trip soon and my lady friend's daughter, Jamie would love to do the Open Water Course. I have been diving for six years and of course I have been very encouraging to Jamie explaining some of what she will have to do. However, Jamie just happen to mention that she has a hole in the heart, she is otherwise healthy, in her early twenties and leads a very physically active life. Jamie has had no problems at all concerning her heart but I really thought that I should check with someone who knows first. Incidentally I know of a British professional soccer player who played for years who was unaware that he had the same problem until he went for a routine medical, he continued to play for many years without any trouble.
So I would appreciate a little advice as to what to tell Jamie.
Thanks,
Martin
Seems that the prior posters have already diagnosed your lady friend's daughter as having patent foramen ovale (PFO), which is curious as a broad, loose and generic term like "hole in the heart" also can refer to ventricular septal defects (VSD) or possibly even to other cardiac abnormalities. Best to inquire what, specificially, is her condition.
If it is PFO, then as a general orientation you might wish to read the following is from my "Ask RSD" column in the April '00 issue of "Rodale's Scuba Diving":
"1. What is patent foramen ovale (PFO)? Larry Lozuk, Dallas, TX
PFO, a type of atrial septal defect, is an abnormal opening between the right and left upper chambers of the heart.
It is normal for blood to flow through a small opening between these two chambers during fetal development when the lungs are inoperative and blood is oxygenated by the mother. At the moment of birth, however, changes in chamber pressures cause this membranous opening to close, shunting blood to the now functioning lungs. While usually permanently sealed by the 3rd month of life, this does not always occur; about one in every four people have an incomplete closure of varying size. Without complete closure, blood can flow from the right to the left side of the heart without passing through the lungs. This causes a decrease in the amount of oxygen reaching the body and may limit exercise tolerance, sometimes severely.
In the absence of shifts in the pressure gradient in these upper chambers of the heart, however, the majority of otherwise healthy persons with PFO, many with only small openings, are unaware they have the condition. It typically requires no treatment in the adult.
Of significance to divers with PFO is the increase in right chamber pressure which occurs with common equalization techniques like the Valsalva maneuver. Under this condition, nitrogen bubbles that can form in the venous bloodstream during decompression may pass directly into the arteries without the filtering action of the lungs. Divers with PFO can develop decompression illness (DCI) manifestations ranging from relatively harmless skin rashes to serious neurological problems such as vertigo or paralysis. Bubbles passing into the brain can obstruct blood vessels, resulting in lesions of various size. Studies of high frequency divers have documented an increased likelihood of large and/or multiple brain lesions, and shown that a high percentage of divers who had otherwise unexplained incidents of DCI turned out to have PFO. In addition, The risk of severe decompression sickness (DCS) appears to be about three to five times greater in those with PFO as compared to the general diving population, although the relationship is much weaker for only mild cases.
PFO is often diagnosed by routine echocardiography, a simple procedure where sound is passed through the chest wall to the heart and its echo measured. If abnormalities are detected or suspected, this may be followed up with a more complicated echocardiogram where the sound transducer is passed down the esophagus to the region of the heart.
Despite some research findings of increased risk of DCI in divers with PFO, the risk is still quite low. Many dive medicine experts do not recommend echocardiogram as a routine procedures in healthy divers. However, if you have signs or symptoms of heart disease, or are concerned about your cardiac status, contact your physician."
In any event, at the time she applies for OW certification she will be required to complete a medical questionnaire and it will specifically ask about cardiac conditions. If she answers truthfully and the training agency is reputable, she will be denied training until given medical clearance to dive. The training agency should be able to direct her to a medical referee. If not, I may be able to help.
Best of luck.
DocVikingo
