Menstrual cycle dependent right-to-left shunting: a single-blinded transcranial Doppler sonography study.
Undersea Hyperb Med
; 32(6): 403-7, 2005.
Article
en En
| MEDLINE
| ID: mdl-16509282
BACKGROUND AND PURPOSE: Menstruation has been described as risk factor for neurological decompression sickness in divers. In considering this for paradoxical gas embolism, we hypothesized that there may be a link between cycle-dependent hormonal changes and the manifestation of a right-to-left shunt (RLS). METHODS: 40 women with a regular cycle of 28 days underwent transcranial Doppler sonography examinations (TCD) on day 1 and on day 15 of the menstrual cycle. Cerebral high intensity transient signs (HITS) proved a RLS. RESULTS: We found a 25% RLS incidence consistent with the literature. In 7 of 10 shunt-positive women it was detected mainly or exclusively on day 15. This difference in PFO detection rate is statistically significant (p = 0.031), indicating more RLS during the peri-ovulatory period. CONCLUSIONS: Our results do not support menstruation as a risk factor for neurological decompression sickness. The peri-ovulatory estrogen peak, which leads to systemic vasodilation, may explain our data. Factors that increase the risk for developing a RLS and thereby paradoxical embolism should be avoided, perhaps including diving during the peri-ovulatory period of the menstrual cycle. Furthermore, contrast PFO testing in fertile females may be most sensitive if conducted mid-cycle.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Defectos del Tabique Interatrial
/
Ciclo Menstrual
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Undersea Hyperb Med
Asunto de la revista:
FISIOLOGIA
Año:
2005
Tipo del documento:
Article
País de afiliación:
Austria
Pais de publicación:
Estados Unidos