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Severe neurological decompression sickness associated with right ventricular dilatation and a persistent foramen ovale

Year: 2025

Type: article

Abstract: We present the case of a 28-year-old female diver who performed a scuba air dive with significant omitted decompression obligation. She developed constitutional and neurological symptoms. Brain magnetic resonance imaging post treatment demonstrated multifocal embolic infarcts and transthoracic echocardiogram with bubble contrast on day three revealed a persistent foramen ovale (PFO) and severe right ventricular (RV) dilatation. We postulate that the high venous bubble load from the provocative decompression caused an increase in pulmonary artery pressure, leading to RV dilatation and increased right to left shunting of bubbles across her PFO, resulting in significant neurological deficits. This mechanism is analogous to that seen in acute thromboembolic pulmonary embolism.

Source: Diving and Hyperbaric Medicine Journal

DOI: 10.28920/dhm55.1.59-64

Authors: Jeremy S Mason, Peter Wilmshurst, Ian C Gawthrope, Neil D Banham

Institutions: Fiona Stanley Hospital, Royal Stoke University Hospital, The University of Notre Dame Australia

Language: English

Topic: Cardiovascular and Diving-Related Complications

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W4408515878

FWCI: 1.174

Cites: 13

Cited by: 2

Related to: 10