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Influence Of Repetitive Open Sea Dives And Physical Exercises On Right-To-Left Shunting In Healthy Divers.
  1. jean-éric Blatteau (je.blatteau{at}infonie.fr)
  1. HIA SAINTE ANNE TOULON, France
    1. christophe Pény (c.peny{at}free.fr)
    1. HIA SAINTE ANNE TOULON, France
      1. jean-michel Pontier (jm.pontier{at}free.fr)
      1. ECOLE DE PLONGEE MARINE NATIONALE TOULON, France
        1. emmanuel Gempp (gempp{at}voila.fr)
        1. IMNSSA TOULON, France
          1. pierre Louge (p.louge{at}free.fr)
          1. ECOLE DE PLONGEE MARINE NATIONALE TOULON, France

            Abstract

            Objective: paradoxical gas embolism through right-to-left (R/L) shunts is considered as a potential cause of certain types of decompression sickness. This study was done to assess whether 4 months of repetitive diving and strenuous exercises lead to an increased prevalence of R/L shunting in a group of military divers. Methods: using a standardized 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 maneuver and type II if present at rest. Results: initial prevalence of R/L shunt was 41%: 6 types I and 1 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 shunt. 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 a R/L shunting. However extreme conditions of repetitive diving and strenuous exercises are not able to cause a permanent modification of R/L permeability over a period of 4 months.

            • decompression sickness
            • diving
            • patent foramen ovale
            • right-to-left shunt
            • transcranial doppler

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