PFO and Diving

[jules]

I had a DCS hit at the end of May. There was nothing unusual in my dive profiles to suggest why I got bent. I didn't dive for 7 days before flying home. Symptoms re-appeared and were worse, so I did 6 hyperbaric chamber treatments. It took two months, but I finally got an appointment with a diving medicine physician. His assessment was a mild DCS II hit. He sent me for a TTE last week and a PFO was found. He is attributing my DCS hit to the PFO. His recommendation is no more diving.

Many of my well-meaning dive buddies, who don't want to see me sitting on shore, have been sending me articles from studies saying that it's okay to dive with a PFO as long as you understand the risks and dive conservatively. I'm not looking to go against the diving physician's recommendation, but it did make me curious.

Is it standard practice to eliminate scuba diving after a DCS hit with a diagnosed PFO? Have any of you been diagnosed and continued diving without having the PFO repaired?

I'm seeing a cardiologist next, but wanted to satisfy my curiosity. I'd appreciate info from anyone willing to share.

 

[Bill Schindler]

I had a DCS hit at the end of May. There was nothing unusual in my dive profiles to suggest why I got bent. I didn't dive for 7 days before flying home. Symptoms re-appeared and were worse, so I did 6 hyperbaric chamber treatments. It took two months, but I finally got an appointment with a diving medicine physician. His assessment was a mild DCS II hit. He sent me for a TTE last week and a PFO was found. He is attributing my DCS hit to the PFO. His recommendation is no more diving.

Many of my well-meaning dive buddies, who don't want to see me sitting on shore, have been sending me articles from studies saying that it's okay to dive with a PFO as long as you understand the risks and dive conservatively. I'm not looking to go against the diving physician's recommendation, but it did make me curious.

Is it standard practice to eliminate scuba diving after a DCS hit with a diagnosed PFO? Have any of you been diagnosed and continued diving without having the PFO repaired?

I'm seeing a cardiologist next, but wanted to satisfy my curiosity. I'd appreciate info from anyone willing to share.

I saw an article recently in either Dive Training or DAN's magazine re: PFO. I would suggest that you find the articles and contact DAN in order to get a better understanding. I have a friend who's wife took a hit due to PFO and had corrective surgery. I believe she can dive now.

 

[HarryH97]

Jules,
If you are being sent in for a TEE, your cardiologist will probably recommend a similar cardiac catheterization process to repair the PFO. Get fixed up in a couple days, rest a bit and you're back in the water.

Sincerely,
H2

 

[Dr. Doug Ebersole]

I'm a cardiologist with an interest in diving medicine. The PFO may or may not be the cause of your DCS. However, as it might be the cause, it should likely be repaired prior to more diving. Thankfully, they can now usually be closed with a percutaneous (non-surgical) approach through a needle stick in your groin similar to a heart cath. You will definitely need to first see a cardiologist and get a TEE (transesophageal echo as opposed to the transthoracic echo you had) to better define the PFO. PM me with further questions or contact info and we can discuss your situation further. Don't worry -- all is not lost! You should be able to dive again!

 

[perche]

I'm a cardiologist with an interest in diving medicine. The PFO may or may not be the cause of your DCS. However, as it might be the cause, it should likely be repaired prior to more diving. Thankfully, they can now usually be closed with a percutaneous (non-surgical) approach through a needle stick in your groin similar to a heart cath. You will definitely need to first see a cardiologist and get a TEE (transesophageal echo as opposed to the transthoracic echo you had) to better define the PFO. PM me with further questions or contact info and we can discuss your situation further. Don't worry -- all is not lost! You should be able to dive again!

As a radiologist I see a few complications after various surgery, percutaneous procedure....
For instance by now we perform a lot of ct-scan to look for pulmonary vein stenosis after RF ablation.

As far I know a diver with a PFO is a normal being human.

Is a percutaneous or surgical closure without risk?
- I'm a little shocked when you said "similar heart cath"; for this kind of "easy and non-invasive (lol)" procedure there is also a low risk but definitely present (stroke for instance) -.
is the risk of percutaneous closure acceptable for a a normal being human?

After this procedure (percutaneous closure) can we have a 100% guarantee to dive again?

After this procedure can we have guarantee to never have a DCS?

Last but not least, since the beginning of percutaneous closure, PFO is a hot topic and getting an essential subject of great interest.........

some thought.

The PFO may or may not be the cause of your DCS.

I couldn't say that better....

regards

François

 

[Dr Deco]

Hello jules:

There are other ways to have venous bubbles arterialize than through a PFO. One needs to see a cardiologist and have this question examined.

There is also information on patent foramen ovale (do a search) on the Ask Dr Deco forum.

Good luck!

Dr Deco :doctor:

Readers, please note the next class in Decompression Physiology is September 10 – 11, 2005 :1book:
http://wrigley.usc.edu/hyperbaric/advdeco.htm