title: Paradoxical gas embolism after SCUBA diving: hemodynamic changes studied by echocardiography.
abstract: Hemodynamic changes induced by self-contained underwater breathing apparatus diving were investigated using Doppler echocardiography. We detected circulating bubbles in both right and left cavities of the heart and in the cerebral circulation in two divers with a large patent foramen ovale. A reduction in the left ventricular preload was suggested by echocardiographic measurements. The decreased cardiac preload was paralleled to a lower stroke volume and cardiac output. These findings were also observed in divers with no evidence of circulating bubbles. In these subjects, pulmonary vascular resistances remained unchanged while an increase was observed in the two divers with arterial bubbles. This increase could promote right-to-left shunting.
authors.affiliation: Institut de Recherche Biomédicale des Armées (IRBA), Brétigny sur Orge, France.
authors.forename: A
authors.initials: A
authors.lastname: Boussuges
authors.forename: J M
authors.initials: JM
authors.lastname: Pontier
authors.forename: B
authors.initials: B
authors.lastname: Schmid
authors.forename: C
authors.initials: C
authors.lastname: Dussault
mesh_terms: D000328:Adult; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology; D004242:Diving / Q000502:physiology*; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D014655:Vascular Resistance / Q000502:physiology