PT  - JOURNAL ARTICLE
AU  - J-E Blatteau
AU  - C Pény
AU  - J-M Pontier
AU  - E Gempp
AU  - P Louge
TI  - Influence of repetitive open sea dives and physical exercises on right-to-left shunting in healthy divers
AID  - 10.1136/bjsm.2007.042226
DP  - 2008 Nov 01
TA  - British Journal of Sports Medicine
PG  - 934--936
VI  - 42
IP  - 11
4099  - http://bjsm.bmj.com/content/42/11/934.short
4100  - http://bjsm.bmj.com/content/42/11/934.full
SO  - Br J Sports Med2008 Nov 01; 42
AB  - 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.