Acute breathing difficulty during swimming or diving may be associated with Immersion Pulmonary Edema (IPE). At SPUMS 2014, Peter Wilmshurst presented a summary of his rich clinical experience. In his opinion, IPE is an underestimated cause of fatalities. Problem with diagnosis of IPE in scuba diving is its rapid evolution. Divers may be overwhelmed with an internal lung flood before they realize the nature of their breathing difficulty and can safely exit the water.
Peter Wilmshurst’s series of cases shows that 79% of all skin DCS have PFO, 10% lung disease and only remaining cases occur in divers with closed PFO due to severe dive exposure. Similar statistics were provided for inner ear DCS and neurological DCS. Other authors dispute association of PFO with spinal form of DCS and say only cerebral DCS appears to be associated. Nevertheless, a large number of DCS cases could be avoided if the diver was aware of PFO and exercised caution.
How safe is the option of transcatheter closure?
Mark Turner, another cardiologist from the United Kingdom, provided a detailed presentation of the procedure, pitfalls and outcomes. The overall outcome: Successful with very low rate of adverse events.