Screening echo for old guy before tech diving?

[ianr33]

This may be a stupid question but is a PFO really more of a contraindication to deco diving as opposed to recreational diving?
My guess would be that even if you have a PFO you are probably safer doing well planned and executed ,conservative deco dives than doing a bunch of 100 foot recreational dives and not paying too much attention to surface intervals,ascent rates and the like.

I would agree that if you are doing a working dive at 500 feet in 32 degree water then all bets are off.

 

[Doc Intrepid]

Not a stupid question. Basically all dives are deco dives. But some require longer deco than others. A PFO is a hole in the wall of the heart that allows seed bubbles to transfer from one side of the circulatory system to the other. If that seed bubble expands, it may then cause a stroke. It doesn't matter if the bubble is caused during the course of a planned decompression dive or a repetitive recreational profile.

That said, dives where you intend to wind up with bubbles, due to lengthy exposures and multiple gasses (e.g. helium), MAY offer a higher incident risk than dives where you do NOT intend to wind up with bubbles.

But a PFO can be problematic either way.

Dr. Deco may offer more details.

 

[dherbman]

The closer to the edge, the more of an issue it would be. In rec, I would thing that a PFO could be adressed by longer safety stops, slower ascents and more conservative profiles.

The issue I see with deeper dives accruing significant deco obligations is the nitrogen loading of tissues with longer half lifes. Perhaps I'm not thinking this through properly, but I'm sure someone with solid knowlege will be along soon to correct me.

Damn Doc! 5K?! Ouch! I'm hoping that is the test using the probe down your throat, rather than the ECG I'm getting.

 

[dherbman]

Here is a link to the post I made on my exam.

Doc, I'm thinking the 5K you were quoted was for a TEE, which is where they shoot from the throat. They imaged my heart with ultrasound and it ran $1800. You can still buy a lot of gas for that, but with any luck, the insurance company will carry it. You see, I've been very short of breath these days and I've got a doctor who wants to cover all the bases..........

 

[Doc Harry]

Here is a link to the post I made on my exam.

Congrats on your study. I see my primary care doc on Friday. That gives me a couple of days to come up with a good story to justify the echo w/ bubble study.....

 

[Saturation]

A screening echocardiogram is not warranted to train to technical dive. I'd be more concerned with the basic experience and the quality of these dives. 100 dives is entry level for technical training. Most who technical dive dive about 100+ a year, at least.

Rationale for it can be found all over scubaboard, but more so in specific tech diving sites such as thedecostop.com

http://www.scubaboard.com/showpost.php?p=531414&postcount=36

http://www.scubaboard.com/showpost.php?p=1359308&postcount=27

http://www.yorkshire-divers.co.uk/forums/showpost.php?p=173529&postcount=25

 

[drbill]

Gulp... 45 is old? I'm way past that. I thought the 50's were the new 30's, the 60's the new 40's and the 80's were the new infant years (due to Depends).

You sound like you could be in better shape than a lot of the 20-somethings I see diving.

 

[Doc Harry]

A screening echocardiogram is not warranted to train to technical dive. I'd be more concerned with the basic experience and the quality of these dives. 100 dives is entry level for technical training. Most who technical dive dive about 100+ a year, at least.

Rationale for it can be found all over scubaboard, but more so in specific tech diving sites such as thedecostop.com

http://www.scubaboard.com/showpost.php?p=531414&postcount=36

http://www.scubaboard.com/showpost.php?p=1359308&postcount=27

http://www.yorkshire-divers.co.uk/forums/showpost.php?p=173529&postcount=25

Thank you for the advice, I do appreciate your input.

 

[Dr Deco]

Hello Doc Harry:

Sorry I neglected to respond to this post. My Bad.

About 20% of people – and divers – have a PFO [with Valsalva augmentation]. It has been noted, however, that 20% of divers with bubbles do not have DCS problems. There does not appear to be a good correlation.

Even with a “resting PFO,” one does not see problems in divers with Doppler-detectable bubbles. It is close to a non-issue.

One might find a problem if bubbles are in the venous return, and there is then a strong exertion. Climbing a ladder on the boat, for example, could be a very provocative event.

Thus, I always suggest removal of heavy gear when reboarding

Dr Deco :doctor: