SCUBA divers with PFO at higher risk for decompression illness

A study of a cohort of SCUBA divers has found that the presence of high-risk patent foramen ovale (PFO), or a hole in the heart, was associated with an increased risk of decompression illness (DCI), also commonly known as the bends. The authors recommend that divers with high-risk PFO should consider either refraining from diving or adhering to a conservative diving protocol.

DCI is a disease in which inhaled nitrogen is dissolved in tissues or blood under a high pressure during a diver’s descent and subsequently forms gas bubbles while they rise, mechanically affecting the tissue or inhibiting blood flow. A PFO enables venous nitrogen bubbles to embolize into the arterial system.

Researchers from Sejong Hospital, Bucheon, South Korea conducted a prospective cohort study of 100 experienced divers who did more than 50 dives per year. Participants had transesophageal echocardiography with a saline bubble test to determine the presence of a PFO and were subsequently divided into high- and low risk groups. They were followed up using a self-reported questionnaire while blinded to their PFO status. The authors report that 12 of 68 divers with PFO (10 of 37 divers with high-risk PFO) experienced DCI.

Ref:Annals of Internal Medicine, https://www.acpjournals.org/doi/10.7326/M23-0260