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Patent foramen ovale and hypobaric decompression

M R Powell1, W T Norfleet, K V Kumar

  • 1Space Biomedical Research Institute, NASA Lyndon B. Johnson Space Center (JSC), Houston, TX 77058, USA.

Aviation, Space, and Environmental Medicine
|March 1, 1995
PubMed
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Gas microbubbles were detected in the left ventricle during a hypobaric decompression study, bypassing the need for a Valsalva maneuver for right-to-left passage. This novel finding highlights potential risks during altitude exposure.

Area of Science:

  • Cardiology
  • Aerospace Medicine
  • Physiology

Background:

  • Echocardiography is crucial for diagnosing cardiac conditions like atrial septal defects.
  • Hypobaric decompression studies investigate physiological responses to reduced atmospheric pressure.
  • Understanding gas microbubble dynamics is vital for diving and aviation safety.

Observation:

  • Gas microbubbles were identified in the left ventricle of a subject undergoing screening for an atrial septal defect.
  • The presence of microbubbles in the left heart occurred without a Valsalva maneuver, indicating spontaneous right-to-left shunting.
  • During hypobaric decompression to 21,000 ft, numerous gas microbubbles were observed in the right heart, but not in the left ventricular outflow tract or middle cerebral artery.

Findings:

Related Experiment Videos

  • A spontaneous right-to-left passage of contrast microbubbles into the left heart and middle cerebral artery was observed.
  • No gas bubbles were detected in the left ventricular outflow tract or middle cerebral artery during simulated high-altitude exposure.
  • This represents a novel observation regarding gas microbubble behavior under hypobaric conditions.

    • Implications:

    • The findings suggest a potential risk of paradoxical embolism in individuals with undiagnosed shunts during hypobaric exposure.
    • Further research is needed to elucidate the mechanisms of gas microbubble transport and retention under reduced pressure.
    • This study underscores the importance of screening for cardiac shunts in individuals exposed to environments with reduced barometric pressure.