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Paradoxical gas embolism after SCUBA diving: hemodynamic changes studied by echocardiography
A Boussuges1, J M Pontier, B Schmid
1Institut de Recherche Biomédicale des Armées (IRBA), Brétigny sur Orge, France.
Scandinavian Journal of Medicine & Science in Sports
|May 23, 2012
Summary
Self-contained underwater breathing apparatus (SCUBA) diving can cause hemodynamic changes, including reduced cardiac output. Patent foramen ovale may increase risks associated with circulating bubbles during diving.
Area of Science:
- Cardiovascular physiology
- Diving medicine
Background:
- Self-contained underwater breathing apparatus (SCUBA) diving is a popular recreational activity.
- Potential risks associated with SCUBA diving include hemodynamic alterations and the formation of circulating bubbles.
Purpose of the Study:
- To investigate the hemodynamic changes induced by SCUBA diving.
- To explore the role of patent foramen ovale in the context of diving-related hemodynamic alterations and bubble formation.
Main Methods:
- Doppler echocardiography was employed to assess hemodynamic parameters in divers.
- Echocardiographic measurements were used to detect circulating bubbles in the heart and cerebral circulation.
Main Results:
- Reduced left ventricular preload, stroke volume, and cardiac output were observed in divers, irrespective of bubble presence.
- Two divers with a large patent foramen ovale exhibited circulating bubbles in cardiac and cerebral circulation.
- Pulmonary vascular resistances remained unchanged in divers without bubbles but increased in those with arterial bubbles, potentially promoting right-to-left shunting.
Conclusions:
- SCUBA diving can induce significant hemodynamic changes, including decreased cardiac output.
- The presence of a patent foramen ovale may be a risk factor for developing circulating bubbles and associated pulmonary vascular changes during SCUBA diving.
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