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Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale

Torti, Sandra Rea ; Billinger, Michael ; Schwerzmann, Markus ; Vogel, Rolf ; Zbinden, Rainer ; Windecker, Stephan ; Seiler, Christian

In: European Heart Journal, 2004, vol. 25, no. 12, p. 1014-1020

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    Titre
    • Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale
    Auteur
    • Torti, Sandra Rea. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    • Billinger, Michael. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    • Schwerzmann, Markus. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    • Vogel, Rolf. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    • Zbinden, Rainer. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    • Windecker, Stephan. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    • Seiler, Christian. Department of Cardiology, University Hospital, CH-3010 Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Heart Journal, 2004, vol. 25, no. 12, p. 1014-1020. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:294067
    Summary
    Background The risk of developing decompression illness (DCI) in divers with a patent foramen ovale (PFO) has not been directly determined so far; neither has it been assessed in relation to the PFO's size. Methods In 230 scuba divers (age 39±8 years), contrast trans-oesophageal echocardiography (TEE) was performed for the detection and size grading (0-3) of PFO. Prior to TEE, the study individuals answered a detailed questionnaire about their health status and about their diving habits and accidents. For inclusion into the study, ⩾200 dives and strict adherence to decompression tables were required. Results Sixty-three divers (27%) had a PFO. Overall, the absolute risk of suffering a DCI event was 2.5 per 104 dives. There were 18 divers (29%) with, and 10 divers (6%) without, PFO who had experienced ⩾1 major DCI events \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \((P=0.016)\) \end{document}. In the group with PFO, the incidence per 104 dives of a major DCI, a DCI lasting longer than 24 h and of being treated in a decompression chamber amounted to 5.1 (median 0, interquartile range [IQR] 0-10.0), 1.9 (median 0, IQR 0-4.0) and 3.6 (median 0, IQR 0-9.8), respectively and was 4.8-12.9-fold higher than in the group without PFO \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \((P{<}0.001)\) \end{document}. The risk of suffering a major DCI, of a DCI lasting longer than 24 h and of being treated by recompression increased with rising PFO size. Conclusion The presence of a PFO is related to a low absolute risk of suffering five major DCI events per 104 dives, the odds of which is five times as high as in divers without PFO. The risk of suffering a major DCI parallels PFO size