The aim of this study was to determine the utility of pulsed Doppler and 2D echocardiography
for the detection and the quantification of circulating bubbles after decompression.
Twenty-three sport divers performed 60 SCUBA dives (mean 32 msw). An evaluation of
circulating bubbles was performed using 2D images one hour after diving. Circulating
bubbles were also detected with pulsed Doppler. The sample volume was placed in the
outflow area of the right ventricle 1 -2 cm below the pulmonary valve. 2D echocardiography
showed circulating bubbles in right cavities of the heart in 32 cases. Short axis
parasternal view and right cavities long axis view were the best incidences. Pulsed
Doppler confirmed the results in these 32 cases and detected circulating bubbles in
seven other cases. Isometric contraction of muscle limb must be performed to increase
the sensitivity of detection. The count of the bubbles may be evaluated when using
a combination of Spencer's and Powell's grading. We conclude that 2D echocardiography
is less accurate than pulsed Doppler in the detection of circulating bubbles after
decompression. Further studies are needed to compare pulsed Doppler guided by 2D echocardiography
to continuous Doppler for the detection of circulating bubbles.
Diving - decompression - gas emboli - echocardiography - Doppler
