EFFECTS OF A PATENT FORAMEN OVALE ON ARTERIAL SATURATION DURING EXERCISE AND ON CARDIOVASCULAR-RESPONSES TO DEEP BREATHING, VALSALVA MANEUVER, AND PASSIVE TILT - RELATION TO HISTORY OF DECOMPRESSION ILLNESS INDIVERS
Pt. Wilmshurst et al., EFFECTS OF A PATENT FORAMEN OVALE ON ARTERIAL SATURATION DURING EXERCISE AND ON CARDIOVASCULAR-RESPONSES TO DEEP BREATHING, VALSALVA MANEUVER, AND PASSIVE TILT - RELATION TO HISTORY OF DECOMPRESSION ILLNESS INDIVERS, British Heart Journal, 71(3), 1994, pp. 229-231
Objective-To determine whether the presence of a patent foramen ovale
could result in significant arterial desaturation and affect the respo
nses of heart rate and blood pressure to physiological manoeuvres and
to determine whether responses differed between those with and those w
ithout prior clinical events associated with a patent foramen ovale. D
esign-Blind controlled study. Setting-Teaching hospital. Patients-Dive
rs with a large patent foramen ovale shown by contrast echocardiograph
y and divided into those who had neurological decompression illness th
at started within 30 minutes of surfacing (group 1), those who had no
history of decompression illness (group 2), and age and sex matched co
ntrol divers who had no evidence of intracardiac shunts (group 3). Mai
n outcome measures-The change in percentage haemoglobin oxygen saturat
ion during treadmill exercise and the response of heart rate and blood
pressure to physiological manoeuvres. Results-There were no significa
nt differences between the three groups but two divers in group 1 show
ed clinically important desaturation during exercise and unusual blood
pressure and heart rate responses to passive tilt. These divers were
notable for having the greatest number of episodes and the most severe
single episode of spinal cord decompression illness. Conclusion-A lar
ge patent foramen ovale may be associated with clinically significant
arterial desaturation and unusual responses of heart rate and blood pr
essure in some healthy subjects.