TY - JOUR
T1 - The impact of performing spirometry on shunting across a patent foramen ovale
AU - Maddox, Ian
AU - Smart, David
AU - Bishop, Warrick
PY - 2009/12
Y1 - 2009/12
N2 - Transient changes in intrathoracic pressure can alter left and right intra-atrial pressures, and may provoke shunting of blood across a patent foramen ovale (PFO). Spirometry causes a transient rise and subsequent fall in intrathoracic pressure that, if performed following a dive on compressed air, could raise the risk of decompression illness by arterialisation of venous bubbles across a PFO. To assess whether spirometry can provoke right-to-left shunting across a patent foramen ovale, a subject with a known PFO, previously identified by bubble contrast transthoracic echocardiography, where shunting was only evident on performing a Valsalva manoeuvre, underwent re-examination whilst performing spirometry. Right-to-left shunting was not evident at rest, but was provoked by performing spirometry. If spirometry is to be performed within two hours of surfacing, this should be regarded as a potential risk for decompression illness.
AB - Transient changes in intrathoracic pressure can alter left and right intra-atrial pressures, and may provoke shunting of blood across a patent foramen ovale (PFO). Spirometry causes a transient rise and subsequent fall in intrathoracic pressure that, if performed following a dive on compressed air, could raise the risk of decompression illness by arterialisation of venous bubbles across a PFO. To assess whether spirometry can provoke right-to-left shunting across a patent foramen ovale, a subject with a known PFO, previously identified by bubble contrast transthoracic echocardiography, where shunting was only evident on performing a Valsalva manoeuvre, underwent re-examination whilst performing spirometry. Right-to-left shunting was not evident at rest, but was provoked by performing spirometry. If spirometry is to be performed within two hours of surfacing, this should be regarded as a potential risk for decompression illness.
KW - PATENT FORAMEN OVALE
KW - Echocardiography
KW - Scuba diving
KW - Decompression illness
M3 - Article
SN - 1833-3516
VL - 39
SP - 213
EP - 215
JO - Diving and Hyperbaric Medicine
JF - Diving and Hyperbaric Medicine
IS - 4
ER -