Quote: (Originally Posted by
Jim)
Several of the people I have spoken with also had contadictary advice from the 'Chamber Man' - with respect they are in no position to diagnose or advise on PFO - you take their advice on this subject at your peril.
The PFO test carries no risk at all - a simple canular in the arm - and watch the ultrasound to see if your own blood / saline solution passes through an opening that shouldn't be there.
Don't take my opinion, I am no Doctor - but if in doubt get the test done and make up your own mind after proper advice.
Mate,
I must confess to being a bit pissed off at the tone of your comments above about the 'Chamber Man". You confess to not being an expert and then dismiss the opinions of a large group of people who are.
There is no doubt that the best way to diagnose a PFO is a bubble contrast trans-oesophageal echocardiogram, and that that is a test that cardiologists do. It is NOT risk free - no medical procedure is. You describe watching bubbles flow across your heart into the left side of your circulation - this can cause problems. I know of at least one person who has had symptoms of CAGE after such a test - but I'm only a hyperbaric physician and therefore in your expert opinion, unfit to comment on the issue.
The VAST majority of cardiologists have very little understanding of diving physiology and decompression sickness. If you know a hyperbaric cardiologist then great, otherwise you should talk to a number of different people. Sometimes people give contradictory advice because the situation is far from clear, although, as I have said, a technical diver with a PFO and an episode of DCI is an indication for investigation. I have certainly referred such people for investigation.
It's not that difficult to get an understanding of the PFO in diving literature, it's not like there's that much of it.
I say again, for a diver to make a properly informed descsion s/he needs to see people with an understanding of both PFO and DCI. In my town that means seeing two people, as there is one cardiologist who does the procedure and about 5 people with a good understanding of DCI.
Dave T