Patent foramen ovale and decompression sickness
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [3]
Overview
Decompression illnesses have been found to be positively associated with patent foramen ovale (5 to 13 fold incresed incidences). The risk increased with increase in patent foramen ovale defect size. [1]. Thus, device closure should be considered in divers with unexplained decompression illness[1] and who wish to continue diving in future.
Decompression sickness in patent foramen ovale
Decompression illness can occur in divers when they ascent from deeper waters to the surface. The change in pressure (high to low) causes formation of gas bubbles from inert gases like nitrogen present in the different parts of the body like joints, spine and skin pores. If nitrogen is forced to come out of solution too quickly, bubbles form in parts of the body causing the signs and symptoms of the "bends" which can be itching skin and rashes, joint pain, sensory system failure, paralysis, and death.These gas bubbles can enter the venous system and finally to the systemic circulation via the inter-atrial communications and can cause complications like ischaemic brain lesions. Thus, scuba diving can lead to decompression illness and other complications in patients of patent foramen ovale
Trial supportive data
In a study done on 230 scuba divers, the incidence of patent foramen ovale was found to be 23%. The incidence of significant decompression illness was found to be approximately 5 to 13-fold increased in divers with patent foramen ovale compared to those without a defect. Additionally, the risk of a decompression illness was positively associated with defect size. It was also shown that the number of ischemic brain lesions were twice as common with presence of patent foramen ovale than without it. Thus, device closure should be considered in divers with unexplained decompression illness[1].
References
- ↑ 1.0 1.1 Torti SR, Billinger M, Schwerzmann M, Vogel R, Zbinden R, Windecker S; et al. (2004). "Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale". Eur Heart J. 25 (12): 1014–20. doi:10.1016/j.ehj.2004.04.028. PMID 15191771.