Open AccessDecompression sickness after a highly conservative dive in a diver with known persistent foramen ovale: Case report
Author(s) -
William Brampton,
Martin Sayer
Publication year - 2021
Publication title -
diving and hyperbaric medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.389
H-Index - 20
eISSN - 2209-1491
pISSN - 1833-3516
DOI - 10.28920/dhm51.1.111-115
Subject(s) - decompression sickness , medicine , patent foramen ovale , decompression illness , decompression , surgery , foramen , shunt (medical) , position statement , foramen ovale (heart) , right to left shunt , hyperbaric oxygen , accidental , hyperbaric oxygenation , percutaneous , physics , acoustics , family medicine
A diver returned to diving, 15 months after an episode of neuro-spinal decompression sickness (DCS) with relapse, after which she had been found to have a moderate to large provoked shunt across a persistent (patent) foramen ovale (PFO), which was not closed. She performed a single highly conservative dive in line with the recommendations contained in the 2015 position statement on PFO and diving published jointly by the South Pacific Underwater Medicine Society and the United Kingdom Sports Diving Medical Committee. An accidental Valsalva manoeuvre shortly after surfacing may have provoked initial symptoms which later progressed to DCS. Her symptoms and signs were milder but closely mirrored her previous episode of DCS and she required multiple hyperbaric oxygen treatments over several days, with residua on discharge. Although guidance in the joint statement was mostly followed, the outcome from this case indicates that there may be a subgroup of divers with an unclosed PFO, who have had a previous episode of serious DCS, who may not be safe to dive, even within conservative limits.