PFO Testing in Canada

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dylanfromwinnipeg

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Messages
25
Reaction score
28
Location
Canada
# of dives
200 - 499
Has any Canadian gotten tested for PFO? How do I go about doing that, just ask my doctor at my next visit? Is there a cost for it?
 
Has any Canadian gotten tested for PFO? How do I go about doing that, just ask my doctor at my next visit? Is there a cost for it?
Dylan, I don't know the cost, but if you're near a diving physician in Canada, he/she might be able to justify it to your Medicare.

Best regards,
DDM
 
You will presumably need a referral from your GP. The bigger issue, of course, is the wait time to get one or more of the tests done in Winnipeg.


How is patent foramen ovale diagnosed?​

Your healthcare provider will ask about your past health and do a physical exam. He or she will also need tests to help make the diagnosis. These include:

  • Transthoracic echocardiography, done on the skin of the chest to see how blood is moving through the heart
  • Transesophageal echocardiography to take ultrasound pictures taken from the esophagus
  • Multidetector CT, as an another way to view the PFO
  • Cardiovascular MRI, as another way to see the PFO
Healthcare providers often pair these tests with a bubble study. In this test, the technician injects saline that has been shaken into a blood vessel. The resulting bubbles can be tracked through the heart with the above imaging tests.

Sometimes, a healthcare provider diagnoses a PFO based on tests that were needed to diagnose some other condition. Other times, the healthcare provider may be looking for a PFO. That might happen, for example, if he or she is looking for possible causes of a stroke.
 
You will presumably need a referral from your GP. The bigger issue, of course, is the wait time to get one or more of the tests done in Winnipeg.


How is patent foramen ovale diagnosed?​

Your healthcare provider will ask about your past health and do a physical exam. He or she will also need tests to help make the diagnosis. These include:

  • Transthoracic echocardiography, done on the skin of the chest to see how blood is moving through the heart
  • Transesophageal echocardiography to take ultrasound pictures taken from the esophagus
  • Multidetector CT, as an another way to view the PFO
  • Cardiovascular MRI, as another way to see the PFO
Healthcare providers often pair these tests with a bubble study. In this test, the technician injects saline that has been shaken into a blood vessel. The resulting bubbles can be tracked through the heart with the above imaging tests.

Sometimes, a healthcare provider diagnoses a PFO based on tests that were needed to diagnose some other condition. Other times, the healthcare provider may be looking for a PFO. That might happen, for example, if he or she is looking for possible causes of a stroke.
To your point, the GP might wonder why the PFO test is being requested. @dylanfromwinnipeg , what is motivating you to get a PFO test?

Best regards,
DDM
 
The motivation is that as I do more deco diving PFO increases my risk of DCS. I’d like to know if I have it so I can get it fixed if necessary.
 

check this out might help you .
 
For better accuracy the minimum test would be the TEE (Transesophageal echocardiography to take ultrasound pictures taken from the esophagus). This is considered an invasive procedure so it would cost more. My wife had DCS experiences in in shallow dives and was tested twice using "Transthoracic echocardiography, done on the skin of the chest to see how blood is moving through the heart". It did not show her PFO. It was only after she experienced a TIA and ha to get full Cardiovascular check up that required a TEE that they found a pretty big PFO. She had it closed not because of diving but her family has "Stroke" history. Our insurance at the time covered the cost because of that. I do not know what the coverage payment structure you have in Canada, but if you are goinng to get a test it should at least be a TEE.
 
The motivation is that as I do more deco diving PFO increases my risk of DCS. I’d like to know if I have it so I can get it fixed if necessary.
That might be a tough sell; that's not standard of care for divers and the risk doesn't necessarily justify the benefit. If you're really bent on it (no pun intended) a diving physician might be able to help you justify it.

For better accuracy the minimum test would be the TEE (Transesophageal echocardiography to take ultrasound pictures taken from the esophagus). This is considered an invasive procedure so it would cost more. My wife had DCS experiences in in shallow dives and was tested twice using "Transthoracic echocardiography, done on the skin of the chest to see how blood is moving through the heart". It did not show her PFO. It was only after she experienced a TIA and ha to get full Cardiovascular check up that required a TEE that they found a pretty big PFO. She had it closed not because of diving but her family has "Stroke" history. Our insurance at the time covered the cost because of that. I do not know what the coverage payment structure you have in Canada, but if you are goinng to get a test it should at least be a TEE.
That's unfortunate about your wife. Did her TTE also use bubble contrast? TTE with bubble contrast is sufficient to detect a clinically significant PFO.

Best regards,
DDM
 
'That's unfortunate about your wife. Did her TTE also use bubble contrast? TTE with bubble contrast is sufficient to detect a clinically significant PFO." Her initial "undeserved hits" happened in the 90's. She and I were Scuba Instructors and all the medical care was done at the Mayo Clinic in Rochester, MN. At that time PFO were already talked about but very few people knew what to do to find them. It was later on with more information coming from Interntional diving forums on the internet that she and I got more information about PFO diagnosis and closure. At the time of her closure (2003) there was only one Cardiologist at Mayo that was using the Amplazter Septal Occluder, and my wife was his 11th patient and she was the first diver.
4 months after her closure my wife did 100 dives including her Trimix certification without any more experiences of DCS. That was 20 years ago. I know of all the other tests that are done now, but back then I don't think that there were enough people doing the other tests.
 
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