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To: techdiver@opal.com

 hgartner@ra*.or* (Harold Gartner) wrote :
	1)  I'd also like to know how a PFO causes a problem on the aterial 
	side when the normally fluid dynamics would seem to make this a remote 
	possibility. Can you educate all of us?
	2)I thought that a good doppler study of the heart should pick up a 
	PFO?  Not that expensive if extra precautions are in order for someone
	who has the defect.
A *good* examination can. i.e. transesophageal duplex doppler ultrasponography
is the ticket. I have seen microemboli pass through an atrial septal defect
from right to left. You're right, a majority of the flow is from left to right
as the ventricular pressure exceeds atrial. However, a small "puff" of fluid
can leak through, go through the system again, and perhaps gain in size.
Good ultasound, and perhaps with some of the new contrast agents on the way, 
PFO may be much easier to visualize. Part of a good diving physical? At 27%
occurence (as this thread maintains), I would think that it should be.

		Dave

David Cloutier
Scripps Clinic & Research Foundation
GCRC
La Jolla, CA 
e-mail cloutier@sc*.ed*

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