bed tilt as a method for PFO detection

[andydormer]

Hi everyone, help and ideas appreciated...

My dissertation is going to be on bed tilt as a method for detecting patent foramen ovale and comparing it to the valsalva manouver.

By tilting the body head down (10 degrees appears sufficient) the blood pools in the upper body. This increases right atrial pressure before the left atrial pressure sees an equivalent increase, thereby causing a brief pressure gradient between the right and left atria. If there is a PFO there may be a right to left shunt detectable by a bubble study and trans thoracic echo.

This is purely a literature review, I can't practice on anyone yet.

I've found papers by Kerr and Johansson who used this technique in research but no details of it being used in clinical practice. I'm also short of details relating to the immediate effects of the tilt.

Any ideas?

Cheers
Andy
Studying BSc Clinical Physiology and Cardiology when not teaching the university dive club

[Scuba Diva]

Hi,

Perhaps you could contact the cardiology department at your local hospital and arrange to talk to somebody who does tilt tests - one of the doctors or the techs.

Also one of the doctors who has done a lot of work on PFO's (and is a medical referee for BSAC) is Peter Wilmshurst at the Royal Shrewsbury Hospital. He might be able to give you some advice if you e-mail him.

[Helen (AKA Hellvet)]

sounds interesting, presumably you've done the pub med searches?
keep us updated... sounds like potentially relevant info to divers

where are you based? another potential contact might be mark turner at Bristol Royal Infirmary, who's done a fair few PFO's... Also DDRC who do a fair bit of diver related research, INM ditto, who might have naval related research, also your local cardio's who you prob have uni links with...