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Joint position statement on persistent foramen ovale (PFO) and diving. South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Sports Diving Medical Committee (UKSDMC)

Citation

Smart, D and Mitchell, S and Wilmshurst, P and Turner, M and Banham, N, Joint position statement on persistent foramen ovale (PFO) and diving. South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Sports Diving Medical Committee (UKSDMC), Diving and Hyperbaric Medicine, 45, (2) pp. 129-131. ISSN 1833-3516 (2015) [Contribution to Refereed Journal]


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Abstract

This consensus statement is the result of a workshop at the SPUMS Annual Scientific Meeting 2014 with representatives of the UK Sports Diving Medical Committee (UKSDMC) present, and subsequent discussions including the entire UKSDMC. Right-to-left shunt across a persistent or patent foramen ovale (PFO) is a risk factor for some types of decompression illness. It was agreed that routine screening for PFO is not currently justifiable, but certain high risk sub-groups can be identified. Divers with a history of cerebral, spinal, inner-ear or cutaneous decompression illness, migraine with aura, a family history of PFO or atrial septal defect and those with other forms of congenital heart disease are considered to be at higher risk. For these individuals, screening should be considered. If screening is undertaken it should be by bubble contrast transthoracic echocardiography with provocative manoeuvres, including Valsalva release and sniffing. Appropriate quality control is important. If a shunt is present, advice should be provided by an experienced diving physician taking into account the clinical context and the size of shunt. Reduction in gas load by limiting depth, repetitive dives and avoiding lifting and straining may all be appropriate. Divers may consider transcatheter device closure of the PFO in order to return to normal diving. If transcatheter PFO closure is undertaken, repeat bubble contrast echocardiography must be performed to confirm adequate reduction or abolition of the right-to-left shunt, and the diver should have stopped taking potent anti-platelet therapy (aspirin is acceptable).

Item Details

Item Type:Contribution to Refereed Journal
Keywords:patent foramen ovale (PFO), cardiovascular, decompression illness, health surveillance, medical society, persistent foramen ovale, transcatheter closure, fitness to dive
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Emergency Medicine
Objective Division:Expanding Knowledge
Objective Group:Expanding Knowledge
Objective Field:Expanding Knowledge in the Medical and Health Sciences
Author:Smart, D (Associate Professor David Smart)
ID Code:110046
Year Published:2015
Web of Science® Times Cited:9
Deposited By:Medicine (Discipline)
Deposited On:2016-07-12
Last Modified:2016-08-16
Downloads:0

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