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Patent foramen ovale and diving
1Centre for Hyperbaric Oxygen Therapy, Military Hospital Brussels, Bruynstraat 200, Brussels 1120, Belgium. peter.germonpre@mil.be
Cardiology Clinics
|January 29, 2005
Summary
Patent foramen ovale (PFO) increases decompression sickness (DCS) risk in divers, though nitrogen bubbles are the main cause. Divers can minimize risk with conservative profiles and nitrox, but PFO warrants caution.
Area of Science:
- Diving Medicine
- Physiology
Background:
- Patent foramen ovale (PFO) is a known risk factor for decompression sickness (DCS) in SCUBA divers.
- Despite adherence to decompression tables, PFO can increase DCS risk.
Purpose of the Study:
- To discuss the role of PFO in DCS risk for SCUBA divers.
- To explore strategies for minimizing DCS risk, including conservative diving practices and the use of nitrox.
- To address the ongoing debate regarding PFO screening for divers.
Main Methods:
- Review of current practices and literature regarding PFO and DCS.
- Discussion of risk mitigation techniques for civilian sports divers.
- Analysis of ongoing research into modified decompression algorithms.
Main Results:
- Nitrogen bubbles are the primary cause of DCS, not PFO.
- Conservative dive profiles, including avoiding mandatory decompression stops and using nitrox on air profiles, can reduce DCS risk.
- PFO screening for all divers remains a subject of discussion due to practical and methodological issues.
Conclusions:
- While PFO increases DCS risk, divers can adopt strategies to minimize nitrogen bubble formation and exposure.
- Further prospective evaluation is needed to determine the relative risk of PFO for DCS and long-term cerebral damage.
- PFO necessitates caution in SCUBA diving until definitive recommendations can be established.