Negative for PFO

[dherbman]

I was checked for a PFO today and thought I'd share the details.

Thanks to erdoc1 for this blip:

Transthoracic Echocardiogram with bubble study

In certain situations, your physician will order an Echocardiogram with a bubble study. The bubble study is added to the basic echocardiographic study. It involves an injection through an arm vein of sterile saline solution (salt water) by a nurse or physician. This will help the sonographer to see if there are any unusual connections within your heart. An intravenous tube (IV) will be inserted into one of your arm veins before the exam begins.

Transesophageal Echocardiogram back to top

A Transesophageal Echocardiogram (TEE) is a procedure performed to evaluate your heart and the surrounding structures. The esophagus lies directly behind the heart, allowing for better quality images generally than those obtained from an echocardiogram from the chest wall. It is especially valuable in patients with valve replacements, history of a stroke, or when adequate images can not be obtained from the chest wall.

To perform the TEE, a small flexible tube containing a small transducer is passed in to the esophagus. Prior to the test, the back of your throat will be numbed first with a medication you will swallow, followed by another medication that will be sprayed into your mouth. You will then be given medication intravenously for sedation. All of this is done to make the procedure more comfortable for you.


Before the Test
You are asked not to eat or drink anything after midnight the night before the test.

The morning of the test, you may take your medications with small sips of water.
It takes about 45 minutes.

ECG with bubble study $1800
TEE $5000+

Guess which one I had performed.

It's a painless procedure that took less than 40 minutes. I was able to watch the monitor as the technician shot from various angles in the process of doing a normal Echocardiogram prior to the bubble study. He probed from my sternum, below the sternum and from above the sternum. The valves and chambers of my heart were clearly visible.

After 20 minutes, a nurse came in and connected a feed for an IV and then injected some saline on the technicians cue. The bubbles were immediately visible in one atrium and appeared like a clear stream that had been muddied. They slowly dissipated and the process was repeated while I coughed and then performed a valsalva maneuver . The technician watched for a disturbance in the flow of bubbles or bubbles present in the other atrium that would indicate leaking between the atriums.

There are acceptable reasons an insurance company will pay for the procedure. Diving is not typically considered to be one of those reasons, so a certain degree of creativity will be required if you would prefer they pay for the procedure.

 

[TSandM]

Congratulations on the good news.

 

[H2Andy]

yeah, no kidding... congratz on the good news

a lot easier to dive without a PFO

 

[Cacia]

creative, hmmm? I am going to have to think about that. Great post packed with information. Does anyone know the percentage of people who have "some degree" of PFO? I thought I heard one of five which seems very high.

 

[*Floater*]

"Between 17% and 35% of the normal population are found to have an anatomical atrial septal defect, or patent foramen ovale (PFO), beyond infancy (1). The incidence among divers who have suffered from serious neurological decompression sickness symptoms was reported to be as high as 61% (2) or 66% (3). This article will present an overview of the condition with emphasis on the implications for the diving population."

from: http://www.gue.com/Research/Exercise/q3_1j.htm

Too bad it costs so much to test for.

 

[Al Mialkovsky]

So Dave you're trying to tell us you're normal?

Yeah right.

 

[Cacia]

"Between 17% and 35% of the normal population are found to have an anatomical atrial septal defect, or patent foramen ovale (PFO), beyond infancy (1). The incidence among divers who have suffered from serious neurological decompression sickness symptoms was reported to be as high as 61% (2) or 66% (3). This article will present an overview of the condition with emphasis on the implications for the diving population."

from: http://www.gue.com/Research/Exercise/q3_1j.htm

Too bad it costs so much to test for.

well, I had heard 20% so I guess it is true... that must explain a lot of "mystery hits" when there has not been a profile violation. I think if a person had an unexplained DCI, then maybe they would want to rule this out if they dive a lot and could afford the study. Now I will read your article. I wonder if DAN is recommending the study for high risk (previous unexplained DCI) divers?


ah... "prophylactic evaluation of divers will increase in the future."

That article is the best I have seen and a keeper.

 

[dherbman]

So Dave you're trying to tell us you're normal?

Yeah right.

I'm just happy to have proof I have a heart.