PFO Diagnosis

[adjuster-jd]

At my physical today I asked my doctor about testing for a PFO and he was happy to prescribe a cardiac echocardiogram with a bubble test.
I was thinking this was a pretty non-invasive external test.
Now, when reading more about PFO online it seems that the test is trans-esophageal echocardiogram? Is that the only way to do it?
This doesnt sound very pleasant..

Any advice / information would be appreciated.

 

[rakkis]

Hmmm. No experience with it. Though I was going to ask my doctor about it at my next physical.

Maybe I'll give it a second thought now

 

[fisherdvm]

I never had it done to me, but I assume that they will numb up your nostril and pass it through your nose and down your throat. Kinda like how you pass a nasogastric tube in a trauma victim...

It is a little uncomfortable to have a tube in your nose, but I dont' think it is bad. We used to have a cardiologist that browse through here once in a while, why don't you look him up in the past post and email him a note??

 

[limeyx]

At my physical today I asked my doctor about testing for a PFO and he was happy to prescribe a cardiac echocardiogram with a bubble test.
I was thinking this was a pretty non-invasive external test.
Now, when reading more about PFO online it seems that the test is trans-esophageal echocardiogram? Is that the only way to do it?
This doesnt sound very pleasant..

Any advice / information would be appreciated.

I think the TEE is the best test, and TTE can give inaccurate results ? (false positives and negatives)

One is on the order of $500 and painless, one on the order of $5000 and can cause quite some discomfort if I remember

 

[do it easy]

I'm guessing that the painful $5000 test is the better one.

 

[TSandM]

Debersole is the cardiologist, I think.

I believe the gold standard is a TEE with bubble test. The TEE is done with sedation, and the transducer is passed through the mouth into the esophagus. This is not much different from upper endoscopy, a common procedure performed for the diagnosis of ulcers or esophagitis. There is mild discomfort from the gag reflex (which is numbed) as the probe is introduced, and little discomfort thereafter. The procedure is generally not remembered, due to the sedative drugs used.

Transesophageal echocardiography gives a much better picture of the atrial septum, which is why it is preferred to transthoracic echocardiography. It is more expensive, because a technician can do a standard echo, but the TEE requires someone who is trained in the procedure of passing the probe. In addition, the patient has to be monitored during the sedation, the drugs have to be administered, and there is recovery time for the patient to awaken.

 

[DandyDon]

I'm guessing that the painful $5000 test is the better one.

:lol: Well put.

And not something I'd think about doing purely as a precaution. As rare as unexpected hits are, I think I'll wait...

So why are you guys interested in PFO exams? Any indicators at all....???

 

[rakkis]

If I had my way, I would do a full body MRI

Why am I interested? To be honest, I would spend hours looking at every little detail if I were to get an MRI. I'm no hypochondriac; I'm just really interested in what makes me tick

It would be interesting to see if I have a PFO. If I did, I would probably dive more conservatively.

 

[eelpout]

In 1993 my wife was on a dive trip to Micronesia, after a couple of days of diving she ended up with s DCS 2 hit. At that time PFO were already being discussed as a problem for divers. She had a TTE done, the did not find a PFO with this test. In the following years she ended up getting a couple of DCS2 hits again, she semi retired from diving.

In 1997 my wife had an "Incident" where half of her body went numb. She went trhough a full cardiovascular chek up at the Mayo Clinic. One of the tests that was required was a TEE. During this test they found a PFO, a pretty large one. We had a week of consultations with the experts about our options. The decision to have the PFO repaired was not based on her continuing to dive. Her family has a history of Bloot Clotting problems so her doctors felt it should get repaired. She had the PFO repaired.

My wife logged 86 dives in 6 months and got her advanced Trimix certification at the same time. My wife averges 125-150 dives a year. We are both diving professionals and spend mostof our spare time in the water.

I had the TEE exam myself. On of my buddies tried to have a TEE, but the procedure did not work for him.

Jim

 

[PacketSniffer]

So why are you guys interested in PFO exams? Any indicators at all....???

If one is venturing into technical diving with mandatory decompression, it is highly prudent to be tested for PFO.

Really, it would also be advantageous for anyone that would be diving. As we all know, every dive is a decompression dive. You bubble on the way up and at the surface. Giving the bubbles a straight path (through a hole) to the arteries is not good.