Markus Schwerzmann, MD; Christian Seiler, MD; Ernst Lipp, MD; Raphael Guzman, MD; Karl O. Lövblad, MD; Martin Kraus, MD; Nils Kucher, MD
Acknowledgments: The authors thank Aija Kinnunen, Marika Kabok, and Liza Needergard for assistance with transesophageal echocardiography.
Requests for Single Reprints: Christian Seiler, MD, Swiss Cardiovascular Center Bern, Department of Cardiology, University Hospital, 3010 Bern, Switzerland; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Schwerzmann, Seiler, Lipp, and Kucher: Swiss Cardiovascular Center Bern, Cardiology, University Hospital, 3010 Bern, Switzerland.
Drs. Guzman and Lövblad: Department of Neuroradiology, University Hospital Bern, 3010 Bern, Switzerland.
Dr. Kraus: Schweizerische Gesellschaft für Unterwasser-und Hyperbarmedizin, Rathausstrasse 11, 8570 Weinfelden, Switzerland.
Author Contributions: Conception and design: M. Schwerzmann, C. Seiler.
Analysis and interpretation of the data: M. Schwerzmann, C. Seiler, K. Lövblad.
Drafting of the article: M. Schwerzmann, C. Seiler.
Critical revision of the article for important intellectual content: M. Kraus.
Final approval of the article: C. Seiler.
Provision of study materials or patients: M. Schwerzmann, C. Seiler, E. Lipp, R. Guzman, N. Kucher.
Statistical expertise: M. Schwerzmann, C. Seiler.
Administrative, technical, or logistic support: M. Schwerzmann, C. Seiler, E. Lipp, R. Guzman, K. Lövblad, M. Kraus, N. Kucher.
Collection and assembly of data: M. Schwerzmann, C. Seiler, E. Lipp, K. Lövblad.
In divers, the significance of a patent foramen ovale and its potential relation to paradoxical gas emboli remain uncertain.
To assess the prevalence of symptoms of decompression illness and ischemic brain lesions in divers with regard to the presence of a patent foramen ovale.
Retrospective cohort study.
University hospital and three diving clubs in Switzerland.
52 sport divers and 52 nondiving controls.
Prevalence of self-reported decompression events, patent foramen ovale on contrast transesophageal echo-cardiography, and ischemic brain lesions on magnetic resonance imaging.
The risk for decompression illness events was 4.5-fold greater in divers with patent foramen ovale than in divers without patent foramen ovale (risk ratio, 4.5 [95% CI, 1.2 to 18.0]; P = 0.03). Among divers, 1.23 ± 2.0 and 0.64 ± 1.22 ischemic brain lesions per person (mean ± SD) were detected in those with and those without patent foramen ovale, respectively. Among controls, 0.22 ± 0.44 and 0.12 ± 0.63 lesion per person were detected (P < 0.001 for all groups).
Regardless of whether a diver has a patent foramen ovale, diving is associated with ischemic brain lesions.
Schwerzmann M, Seiler C, Lipp E, et al. Relation between Directly Detected Patent Foramen Ovale and Ischemic Brain Lesions in Sport Divers. Ann Intern Med. 2001;134:21–24. doi: 10.7326/0003-4819-134-1-200101020-00009
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Published: Ann Intern Med. 2001;134(1):21-24.
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