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Dive Medicine & Fitness: Discuss So... I got the bends in the General Diving Forums forums: Before anyone undergoes a test for PFO they should be prepared for a positive result, I was lucky that I ...

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  #11 (permalink)  
Old 07-04-08, 10:47 AM
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Before anyone undergoes a test for PFO they should be prepared for a positive result, I was lucky that I was treated by the head of hyperbaric medicine and he put the PFO risk in perspective.

There is no doubt a PFO is an added risk but it really only comes into it's own when combined with other factors, if it were the smoking gun many believe it to be with an estimated 1 in 3 divers having one, the chambers would full every day.

Basically what I'm trying to say is don't be influenced by the well meaning ''go get a test'' brigade without thinking it through, also I found this helpful DAN Divers Alert Network : Patent Foramen Ovale: Is It Important to Divers?

Good luck.

Safe diving,
Steve
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  #12 (permalink)  
Old 07-04-08, 11:04 AM
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So what is actually involved in being tested for a PFO.
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  #13 (permalink)  
Old 07-04-08, 11:35 AM
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Originally Posted by pressure tested
So what is actually involved in being tested for a PFO.
Echocardiography - Wikipedia, the free encyclopedia and I believe some use an ultrasound.

Safe diving,
Steve
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  #14 (permalink)  
Old 08-04-08, 04:48 PM
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Quote:
Originally Posted by pressure tested
So what is actually involved in being tested for a PFO.
I've just come back from one just now actually.

First step was echo cardio-gram, basically just to check that your heart is normal and if there are visible signs of a PFO. Mine showed up normal, but as I had an 'undeserved bend' (there's a thread on here about it for background) he then did a contrast test.

This involved injecting a solution mixed with your own blood in to your blodd stream to test for any 'shunting' between atrium in the heart.

Mine came up positive, so there you go.

It's up to you whether you want it done or not, but I'd be a tad wary about some of the advice in this thread.

I have never once suffered from a migraine.

If 10% of the population have a PFO, then why would this shoot up to 33% in the case of divers?

I'm bloody glad I found in the way I did on a fairly long but shallow dive near a pot.
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Old 08-04-08, 05:09 PM
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Quote:
Originally Posted by RobbieS
....
If 10% of the population have a PFO, then why would this shoot up to 33% in the case of divers?
...
The general view is that 33% of the general (and diving) population (roughly) have a PFO. Its a fact that 100% of people have had one. The PFO "heals" after birth and gradually closes. I understand that if the fusing of the heart muscle is not complete it can tear under the stress of a bad shunt. Also (again my understanding) you can get a flap of tissue that forms over the hole and this too can be dislodged by a heavy shunt.

Clearly its not a very cut and dried issue and it is statistically an fact that you can dive with a PFO and never get hit.

Having researched the area for a while (the missus has migranes and has had the test) it seems to me the best thing is to avoid microbubble formation as much as possible by use of modern decompression techniques like deep stop and above all avoid shunts after a dive. The common cause of a shunt is the valsalva technique for equalising. Learn other techniques as much as possible and avoid equalising at all during the ascent phase by improved buoyancy control.

Don't expect many people to actually know squat about the PFO and certainly the general medical profession (as opposed to dive specialists) have a lower knowledge baseline than many divers. My missus was tested by an NHS hospital and was first given the wrong test. On the second attempt about half a dozen doctors turned up as they had never seen the procedure before. One idiot amongst them commented "waste of money". Luckily for that individual it was the missus on the table not me or he might have learnt a little about dentistry that afternoon

Chris
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  #16 (permalink)  
Old 08-04-08, 05:14 PM
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Quote:
Originally Posted by RobbieS
I have never once suffered from a migraine.
AIUI migraines are a common factor with people found to have PFOs, and it is specifically migraines with aura. You can have a PFO without the migraines and you can have migraines without a PFO. The likelyhood of there being a PFO is higher when there is migraine with aura.

Quote:
If 10% of the population have a PFO, then why would this shoot up to 33% in the case of divers?
I thought the commonly quoted number was 25% (1 in 4) of the general population with slightly higher incidence in males.
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  #17 (permalink)  
Old 08-04-08, 05:15 PM
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The 10% figure was from the cardiac specialist I saw today, I guess that's part of the problem, a lot of conflicting information out there.
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  #18 (permalink)  
Old 08-04-08, 05:15 PM
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loads of reasons why you could have gotten a bend and be perfectly fine to dive .

was it :
exceptionaly cold , did you have a few beers the night before , did you drink enough water . have you done this profile b4 , where you anxious about the dive . tight fighting suit . knife/other strap too tight .
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  #19 (permalink)  
Old 08-04-08, 05:20 PM
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Quote:
Originally Posted by RobbieS
The 10% figure was from the cardiac specialist I saw today, I guess that's part of the problem, a lot of conflicting information out there.
It depends on what you define as a clinical PFO. Basically its a hole. A tiny hole might not be enough for your cardiac specialist to consider it clinical. The 33% of all humans figure comes from autopsy data (again as best I know from the research I did).

Chris
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Old 08-04-08, 05:22 PM
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Fair enough.

All I know is after the bend I've had it's really put me off. In fact I'm going to delete the other thread I just started.
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