PFO Testing in Canada

[Johnoly]

As suspected they both had PFO's and both got them fixed.

All of us were covered by Alberta Health Care so no cost.

WOW! Just curious,, about how long total weeks/months was it for your buddies from diagnosis to hospital surgery departure ?

 

[nadwidny]

WOW! Just curious,, about how long total weeks/months was it for your buddies from diagnosis to hospital surgery departure ?

Around 6 months if I recall.

 

[Macfod]

That might be a tough sell; that's not standard of care for divers and the risk doesn't necessarily justify the benefit. If you're really bent on it (no pun intended) a diving physician might be able to help you justify it.


That's unfortunate about your wife. Did her TTE also use bubble contrast? TTE with bubble contrast is sufficient to detect a clinically significant PFO.

Best regards,
DDM

I Had TOE test 7 years ago but not pfo discovered..but a simple bubble test detected it.
Been diving since with a skin rash on abdomen recently after not diving nitrox etc…silly! having a echocardiogram test next week to as precautionary measure and to discuss possible closure.

 

[rjack321]

That's unfortunate about your wife. Did her TTE also use bubble contrast? TTE with bubble contrast is sufficient to detect a clinically significant PFO.

Best regards,
DDM

Curious where transcranial doppler (TCD) is ranked nowadays? I had one done many years ago (decade+). At the time it was justified as sufficient to detect a clinically significant PFO.

 

[Duke Dive Medicine]

Curious where transcranial doppler (TCD) is ranked nowadays? I had one done many years ago (decade+). At the time it was justified as sufficient to detect a clinically significant PFO.

Transcranial doppler will detect a clinically significant shunt but it's not specific for PFO.

Best regards,
DDM

 

[Duke Dive Medicine]

I Had TOE test 7 years ago but not pfo discovered..but a simple bubble test detected it.
Been diving since with a skin rash on abdomen recently after not diving nitrox etc…silly! having a echocardiogram test next week to as precautionary measure and to discuss possible closure.

If the TOE didn't use bubble contrast then it could definitely miss a PFO. Glad it got detected and you have a plan going forward!

 

[Scubagermany]

We do not rely on a TTE as a screening to detect a PFO in Germany. While its Sensitivity is good, it is not good enough (around 85%). That gets worse if your patient does not give you perfect conditions if he is a smoker or overweight. The TEE is much better giving you about 99 percent of sensitivity whilst having a lot less intervening factors to make your examination hard to evaluate.

Of course here we are in a system where medical procedures can be done quite cheaply.

 

[Macfod]

I had an echocardiogram this week and it couldnt detect any pfo similar to when I had a TEE initially and it couldn’t detect it. Only a bubble test has so far…

 

[Duke Dive Medicine]

I had an echocardiogram this week and it couldnt detect any pfo similar to when I had a TEE initially and it couldn’t detect it. Only a bubble test has so far…

An echocardiogram without bubble contrast isn't sensitive enough to detect PFO, so it makes sense that it wasn't picked up on the echo you had this week.

Best regards,
DDM

 

[TooCold]

Your post was quite a while ago (recently revived). Did you get tested, or are you still pursuing this? Outcome?

In case it's still relevant, to answer your questions directly:

Has any Canadian gotten tested for PFO?

Yes. After returning from a dive trip where I took an "undeserved" DCS hit that included some CNS symptoms, I was tested. TTE bubble study and cardiorespiratory exercise (stress) test including ECG.

How do I go about doing that, just ask my doctor at my next visit?

I'm in BC. I reported my DCS experience to my GP and she ordered the tests. The history and my desire to keep diving was enough to convince her.

Is there a cost for it?

Not for me, and probably not for you as long as your referring physician considers it medically necessary. In BC (and I'm guessing other provinces) the GP has ministry guidelines to follow when referring patients for tests or to a specialist. They are supposed to balance medical necessity vs cost (resource demand on the system). Another GP may have taken the attitude that testing was not medically necessary and that I should just refrain from the "high-risk" activity. If that had happened I would have tried other GP's.

One observation: good advice from @Duke Dive Medicine, but that isn't a reason not to get tested if you're concerned. If you're cleared you're done; you only need to carefully consider risks vs benefits of treatment if a PFO is found.