Influence of repetitive open sea dives and physical exercises on right-to-left shunting in healthy divers

Objective:Paradoxical gas embolism through right-to-left (R/L) shunts is considered as a potential cause of certain types of decompression sickness.Aim:To assess whether 4 months of repetitive diving and strenuous exercises would lead to an increased prevalence of R/L shunting in a group of military...

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Bibliographic Details
Published in:British journal of sports medicine 2008-11, Vol.42 (11), p.934-936
Main Authors: Blatteau, J-E, Pény, C, Pontier, J-M, Gempp, E, Louge, P
Format: Article
Language:English
Subjects:
Adult
Decompression - adverse effects
Decompression Sickness - diagnostic imaging
Decompression Sickness - etiology
Diving
Diving - physiology
Embolism, Air - complications
Embolism, Air - diagnostic imaging
Embolism, Paradoxical - complications
Embolism, Paradoxical - diagnostic imaging
Embolisms
Exercise
Exercise - physiology
Foramen Ovale, Patent - complications
Humans
Investigations
Military Personnel
Permeability
Pulmonary arteries
Pulmonary Circulation - physiology
Sports medicine
Ultrasonography, Doppler, Transcranial
Veins & arteries
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Summary:Objective:Paradoxical gas embolism through right-to-left (R/L) shunts is considered as a potential cause of certain types of decompression sickness.Aim:To assess whether 4 months of repetitive diving and strenuous exercises would lead to an increased prevalence of R/L shunting in a group of military divers.Methods:Using a standardised contrast-enhanced transcranial Doppler technique, 17 divers were re-examined for the presence of a R/L shunt 4 months after their initial examinations. R/L shunts were classified as type I if observed only after a straining manoeuvre, and type II if present at rest.Results:Initial prevalence of R/L shunt was 41%: six type I shunts and one type II. At the second examination, prevalence was 47%, with the appearance of one type I shunt that was not previously present. We found no significant increase in the prevalence and size of R/L shunts.Conclusion:It is speculated that diving-related phenomena, such as variations in right atrial pressures during the end stages of or events immediately after a dive could generate an R/L shunt. However, extreme conditions of repetitive diving and strenuous exercises do not cause permanent modification in R/L permeability over a period of 4 months.
ISSN:0306-3674
1473-0480
DOI:10.1136/bjsm.2007.042226