PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 2574256

Relation between interatrial shunts and decompression sickness in divers.

P T Wilmshurst·J C Byrne·M M Webb-Peploe
View original source ↗Export metadata ↓

Abstract

The prevalence of right-to-left interatrial shunts was determined by contrast echocardiography in a blind comparison of 61 divers who had had decompression sickness, divided into four predetermined clinical subgroups, and a control group of 63 who had not. The prevalence of shunt was 15/63 in the controls and did not differ significantly in 24 divers with onset of neurological symptoms more than 30 minutes after surfacing (4/24) or 6 with joint pain only (1/6). In divers who had neurological symptoms within 30 minutes of surfacing the prevalence of shunt was 19/29, significantly higher. Rashes soon after surfacing were related to shunts but late rashes were not.

Explore related subjects

Decompression SicknessEchocardiographyEmbolism, AirFemaleHeart Septal Defects, AtrialHumansIntracranial Embolism and ThrombosisMaleNeurologic ExaminationPrevalenceRisk FactorsSingle-Blind MethodTime FactorsJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P T Wilmshurst, J C Byrne, M M Webb-Peploe. 1989-12-02. Relation between interatrial shunts and decompression sickness in divers.. https://doi.org/10.1016/s0140-6736(89)91911-9

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases.

INTRODUCTION: Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data. We reviewed the development of these protocols and offer an alternative treatment table more suitable for monoplace chambers that has proven effective in the treatment of DCS in patients presenting to our facility. METHODS: We reviewed the outcomes for 140 cases of DCS in civilian divers treated with the shorter tables at our facility from January 1983 through December 2002. RESULTS: Onset of symptoms averaged 9.3 h after surfacing. At presentation, 44% of the patients demonstrated mental aberration. The average delay from onset of symptoms to treatment was 93.5 h; median delay was 48 h. Complete recovery in the total group of 140 patients was 87%. When 30 patients with low probability of DCS were excluded, the recovery rate was 98%. All patients with cerebral symptoms recovered. Patients with the highest severity scores showed a high rate of complete recovery (97.5%). DISCUSSION: Short oxygen treatment tables as originally described by Hart are effective in the treatment of DCS, even with long delays to definitive recompression that often occur among civilian divers presenting to a major Divers Alert Network referral center.

Decompression Sickness↗
PubMed2006

[The heart and underwater diving].

Cardiovascular examination of a certain number of candidates for underwater diving raises justifiable questions of aptitude. An indicative list of contraindications has been proposed by the French Federation of Underwater Studies and Sports but a physiopathological basis gives a better understanding of what is involved. During diving, the haemodynamic changes due not only to the exercise but also to cold immersion, hyperoxaemia and decompression impose the absence of any symptomatic cardiac disease. Moreover, the vasoconstriction caused by the cold and hyperoxaemia should incite great caution in both coronary and hypertensive patients. The contraindication related to betablocker therapy is controversial and the debate has not been settled in France. The danger of drowning makes underwater diving hazardous in all pathologies carrying a risk of syncope. Pacemaker patients should be carefully assessed and the depth of diving limited. Finally, the presence of right-to-left intracardiac shunts increases the risk of complications during decompressionand contraindicates underwater diving. Patent foramen ovale is a special case but no special investigation is required for its detection. The cardiologist examining candidates for underwater diving should take all these factors into consideration because, although underwater diving is a sport associated with an increased risk, each year there are more and more people, with differing degrees of aptitude, who wish to practice it.

Decompression Sickness↗