Prevention of work-related Decompression Illness Events by Detection of a Cardiac right-to-left Shunt

A 44-year-old tunnel worker was studied who suffered from several unexplained decompression illness events for almost 15 years. This caisson worker was affected after standard pressure profiles that did not cause symptoms of decompression illness in his colleagues on the same shift. Transesophageal...

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Bibliographic Details
Published in:Scandinavian Journal of Work, Environment ＆ Health Environment ＆ Health, 2004-08, Vol.30 (4), p.331-333
Main Authors: KÜTTING, Birgitta, TOMANDL, Bernd, DREXLER, Hans
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiology. Vascular system
Case report
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Decompression sickness
Decompression Sickness - complications
Decompression Sickness - prevention & control
Diseases
Diving
Embolisms
Germany
Heart
Heart Septal Defects, Atrial - complications
Heart Septal Defects, Atrial - diagnosis
Heart Septal Defects, Atrial - physiopathology
Heart septum
Humans
Lesions
Male
Medical sciences
Occupational Diseases - complications
Occupational Diseases - prevention & control
Patent foramen ovale
Pressure reduction
Symptoms
Transesophageal echocardiography
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Summary:A 44-year-old tunnel worker was studied who suffered from several unexplained decompression illness events for almost 15 years. This caisson worker was affected after standard pressure profiles that did not cause symptoms of decompression illness in his colleagues on the same shift. Transesophageal echocardiography revealed an atrial septal defect (grade II) in this otherwise healthy man. Cranial magnetic resonance imaging showed ischemic brain lesions. Among divers, patent foramen ovale, the most common cause of cardiac right-toleft shunts, was shown to increase the risk for decompression illness events by a factor of 4.5 and to double the risk of ischemic brain lesions. Hyperbaric workers with symptoms of unexplained decompression illness, even if they are only slight, should immediately be transferred to a cardiologist so that a cardiac right-to-left shunt will not be overlooked.
ISSN:0355-3140
1795-990X
DOI:10.5271/sjweh.803