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>So, to my questions... Is there any relationship between PFOs and heart 
>murmors?  Does having one suggest a greater chance of having the other?  
>Is an asymptomatic heart murmor as I've described any cause for concern
>or caution as it relates to diving?

Keep in mind that a heart murmur represents simply a turbulent flow of 
blood. Since there can be a whole  variety of anatomic problems that 
cause turbulance (malformed or diseased valves, abarrent blood vessels or 
take-offs, holes in various septae/walls narrowed "harded" arteries), 
you'd expect each to create a different pattern of murmur, and indeed 
they do. That's the real reason for docs to use stethescopes (not to just 
hang around our necks to look cool). Docs have been diagnosing various 
heart anomalies merely by listening to the *pattern* of the murmur for 
almost a couple of centuries now before the advent of all this 
new-fangled technology. So, there is a whole list of *different* problems 
all creating *different* murmurs.

So, in answer to your question. *CAN* a PFO cause a murmur...sure, if 
there is sufficient flow turbulance to make a noise. The less symptomatic 
the PFO, the less the flow, the less turbulance, the quiter the murmur, 
until there is no functional problem (no flow = no murmur).

Keep also in mind, that there are such animals as "functional" or 
physiologic murmurs in kids where a *NORMAL* heart is pumping so much 
blood out to a growing kid that there is some turbulance kicked up, hence 
a murmur. They outgrow them and there is no residual problem (there never 
really was one in the first place).

Like so much in medicine (and life in general), taking one single finding 
out of context causes folks more confusion (and anxiety) than looking at 
an entire collection of evidence. 

Hope medically that doesn't stir up the silt too badly.

Robb Wolov 

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