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Posted : May 24, 2007
Hi Dr Firth
I had a severe spinal bend in August last year which was treated with several sessions in a hyperbaric chamber. We'd done a weekend's diving in Oban, the dives were easy, relatively shallow and with good profiles. I was not ill, cold, stressed, dehydrated, fatigued or hung over, I'm fit, thin, and don't smoke. I am an experienced diver and at no time did I have a sudden ascent. After treatment I had an echocardiogram with bubble study which showed the probability of a PFO. I had surgery to repair this last week, however during the procedure the surgeon was unable to detect the PFO so could not close it. I've been told I will have another bubble study in a few weeks. I am confused and frustrated - if I have a PFO, why could it not be detected, and if the first test was flawed, why did I get such a bad bend from a very innocuous (the chamber doctors words) dive profile? I was really hoping to get back into the water by the end of the year, can you shed any light on this matter?
Thanks for your advice


Answer
Posted : May 24, 2007
Hello and thanks for the query. This is an uncommon situation - there are several types of abnormal communication between the chambers of the heart, of which PFO is only one, albeit the most common. These others, such as atrial septal defects (ASD), may give a positive result on the bubble check but be difficult to detect at operation if they are small. You can also get right to left shunting from pulmonary arteriovenous malformations, ie. abnormal tangles of blood vessels in the lungs. This might explain the bend, however this would not give you a positive bubble study. A further bubble study is probably the next best step and I'd be interested to hear what it shows.
Kind regards, Dr O
Answer provided by Dr Oliver Firth
Dr Ollie Firth
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