@article {Blatteau934, author = {J-E Blatteau and C P{\'e}ny and J-M Pontier and E Gempp and P Louge}, title = {Influence of repetitive open sea dives and physical exercises on right-to-left shunting in healthy divers}, volume = {42}, number = {11}, pages = {934--936}, year = {2008}, doi = {10.1136/bjsm.2007.042226}, publisher = {British Association of Sport and Excercise Medicine}, abstract = {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}, URL = {https://bjsm.bmj.com/content/42/11/934}, eprint = {https://bjsm.bmj.com/content/42/11/934.full.pdf}, journal = {British Journal of Sports Medicine} }