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Related Experiment Videos

Relation between interatrial shunts and decompression sickness in divers.

P T Wilmshurst1, J C Byrne, M M Webb-Peploe

  • 1Department of Cardiology, St Thomas' Hospital, London.

Lancet (London, England)
|December 2, 1989
PubMed
Summary
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Right-to-left interatrial shunts are more common in divers experiencing neurological decompression sickness within 30 minutes of surfacing. This finding suggests a link between shunts and severe decompression sickness symptoms in divers.

Area of Science:

  • Cardiology
  • Diving Medicine
  • Neurology

Background:

  • Decompression sickness (DCS) is a risk for divers.
  • The role of cardiac shunts in DCS is debated.
  • Right-to-left interatrial shunts may affect gas bubble transit.

Purpose of the Study:

  • To investigate the prevalence of right-to-left interatrial shunts in divers with and without decompression sickness.
  • To determine if shunt prevalence differs based on DCS clinical presentation.

Main Methods:

  • Contrast echocardiography was used for shunt detection.
  • A blind comparison was conducted between divers with DCS and a control group.
  • Divers with DCS were categorized into clinical subgroups.

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Main Results:

  • Shunt prevalence was 15/63 in controls.
  • Shunt prevalence was significantly higher (19/29) in divers with neurological DCS within 30 minutes of surfacing.
  • No significant difference in shunt prevalence was observed in divers with delayed neurological symptoms or joint pain only.

Conclusions:

  • Right-to-left interatrial shunts are significantly more prevalent in divers with acute neurological decompression sickness.
  • The presence of a shunt may be a risk factor for developing severe neurological DCS.
  • Early rashes after surfacing were associated with shunts, unlike late rashes.