Ali Erdal Gunes1, Maide Cimsit2. 1. Harran University School of Medicine, Faculty of Medicine, Department of Underwater and Hyperbaric Medicine, Osmanbey Campus, 63300, Sanliurfa, Turkey, aerdalg@gmail.com. 2. Istanbul University, Istanbul Faculty of Medicine, Underwater and Hyperbaric Medicine, Istanbul, Turkey.
Abstract
BACKGROUND: The underwater environment presents physiological challenges for the cardiovascular, renal and pulmonary systems. Increases in external hydrostatic pressure reduce the capacity of the venous compartment and cause blood to move toward the lung. The aim of this study was to evaluate retrospectively electrocardiographic (ECG) changes in a cohort of professional divers. METHODS: Between January 2009 and January 2012, 225 randomly selected professional divers, 204 male (91%) and 21 female (9%) attended our clinic for their biannual diving medical assessment. Their ECG records were evaluated retrospectively. RESULTS: The most common ECG abnormality observed was incomplete right bundle branch block (IRBBB) in 30 divers (13.3%). Eleven divers (4.9%) showed right QRS axis deviation (seven with IRBBB). Six divers had a sinus tachycardia; in four divers there was early repolarization; three divers had ventricular extrasystoles; one diver had ST elevation in lead V3; there was one with sinus arrhythmia and another with T-wave inversion in leads V2, V3 and aVF. These ECG changes were evaluated retrospectively by a cardiologist who made various recommendations for further review including bubble contrast echocardiography for IRBBB. CONCLUSIONS: No serious ECG abnormalities were identified, but IRBBB should be further investigated because of its association with persistent (patent) foramen ovale. Rapid cardiological review of ECGs could be achieved using modern communications technology, such as telecardiography, and further clinical investigations directed by specialist recommendation arranged promptly if indicated.
BACKGROUND: The underwater environment presents physiological challenges for the cardiovascular, renal and pulmonary systems. Increases in external hydrostatic pressure reduce the capacity of the venous compartment and cause blood to move toward the lung. The aim of this study was to evaluate retrospectively electrocardiographic (ECG) changes in a cohort of professional divers. METHODS: Between January 2009 and January 2012, 225 randomly selected professional divers, 204 male (91%) and 21 female (9%) attended our clinic for their biannual diving medical assessment. Their ECG records were evaluated retrospectively. RESULTS: The most common ECG abnormality observed was incomplete right bundle branch block (IRBBB) in 30 divers (13.3%). Eleven divers (4.9%) showed right QRS axis deviation (seven with IRBBB). Six divers had a sinus tachycardia; in four divers there was early repolarization; three divers had ventricular extrasystoles; one diver had ST elevation in lead V3; there was one with sinus arrhythmia and another with T-wave inversion in leads V2, V3 and aVF. These ECG changes were evaluated retrospectively by a cardiologist who made various recommendations for further review including bubble contrast echocardiography for IRBBB. CONCLUSIONS: No serious ECG abnormalities were identified, but IRBBB should be further investigated because of its association with persistent (patent) foramen ovale. Rapid cardiological review of ECGs could be achieved using modern communications technology, such as telecardiography, and further clinical investigations directed by specialist recommendation arranged promptly if indicated.
Entities:
Keywords:
Diving at work; Diving research; Electrocardiography; Fitness to dive; Health status
Authors: V K Malhotra; Navreet Singh; R S Bishnoi; D S Chadha; P Bhardwaj; H Madan; R Dutta; A K Ghosh; S Sengupta; P Perumal Journal: Med J Armed Forces India Date: 2015-08-31
Authors: Jonathan H Kim; Peter A Noseworthy; David McCarty; Kibar Yared; Rory Weiner; Francis Wang; Malissa J Wood; Adolph M Hutter; Michael H Picard; Aaron L Baggish Journal: Am J Cardiol Date: 2011-02-04 Impact factor: 2.778
Authors: Y L Liao; L A Emidy; A Dyer; J S Hewitt; R B Shekelle; O Paul; R Prineas; J Stamler Journal: J Am Coll Cardiol Date: 1986-03 Impact factor: 24.094