When she isn't working at The University of Texas Health Science Center at Houston (UTHealth），休斯顿的现年55岁的卡罗琳·沃尔布雷希特（Caroline Wolbrecht）喜欢潜水。

However, that hobby was put in jeopardy due to a patent foramen ovale (PFO), a heart condition that she didn't even know she had for years.

The foramen ovale, the hole between the left and right atria of the heart, is present in everyone before birth and allows blood to bypass a baby's lungs before the are fully developed. According to the美国心脏协会，在75％的病例中出生婴儿后，卵形卵形关闭。但是，在25％的人中，它保持开放或专利 - PFO。

"Most people with a PFO have no symptoms at all, but in some cases, like Caroline's there are complications that require intervention," saidAbhijeet Dhoble医学博士，心血管医学副教授，结构性心脏干预主任麦戈文医学院at UTHealth, who sees patients at但医生, the clinical practice of McGovern Medical School.

Wolbrecht became a certified diver in 1990. After a couple of years, Wolbrecht stopped diving to raise her family, picking it up again in 2017 as an empty nester.

她说：“在开放水认证期间，我有几例严重的疲劳和头晕，但我只是推动并将其归因于游泳池上下几次，以进行各种训练。”

在多一天的潜水旅行中，她会发展一种称为“皮肤弯曲”的减压疾病（DC）。凭借皮肤弯曲，皮肤会瘙痒并变成红色或质地大理石。

根据Divers Alert Network(DAN), skin bends are usually a mild form of DCS, but disregarding it can sometimes lead to more serious complications.

"My skin bends always first manifested as a rash in the bend of my elbow before running down my forearm to my wrist. If I ignored the symptoms and kept diving, the rash would show up on my lower abdomen, hips, and outside breast area. This extended rash would be accompanied by mild to moderate muscle soreness," Wolbrecht said.

On a multiday diving trip in 2018, she once again developed a rash that spread to the different areas of her body. The next year, the symptoms she developed were much worse.

经过三天的潜水，沃尔布雷希特（Wolbrecht）在肘部的弯曲中出现了皮疹。一天后，它进一步传播。

"I showed my husband the rash on my forearms, abdomen, and hips but we both dismissed it as being some sort of heat rash from my wetsuit," she said. "But after a hot shower I began to feel tired and dizzy. When things didn't seem to be getting any better, I told my husband that I should probably go to the clinic at the resort and get checked out. When I stood up, my knees buckled under me."

沃尔布雷希特（Wolebrecht）开发了II型DCS，一种更严重的疾病形式，包括麻木，刺痛和手臂，腿部或两者兼而有之。当她参观度假村的诊所时，他们给了她的氧气处理，以帮助抵消她系统中的氮。

诊所的医生强烈建议她不要在旅行的其余时间内潜水，并告诉她，由于她已经开发了这种更严重的DC，因此更有可能再次发生副作用。

When Wolbrecht returned to Houston, she researched what could be causing the symptoms after multiday dives. On one particular blog post, there were several comments from fellow divers explaining that they had experienced similar symptoms and discovered they had a PFO.

“正是这样的评论使我决定我需要去看医生。由于我为Uthealth工作，我拉起了目录，发现有一个心脏病专家在我家附近的UT医生诊所看过病人，”沃尔布雷希特说。

Konstantinos Charitakis, MD, ordered a transthoracic echocardiogram (TTE) with a bubble study for Wolbrecht that confirmed a PFO. Charitakis is an associate professor of cardiovascular medicine at McGovern Medical School.

沃尔布雷希特（Wolbrecht）被告知她有三个选择：完全停止潜水，限制她的潜水或关闭PFO。她选择了第三种选择，并被转介到该过程中。

Her PFO was closed on Oct. 10, 2019, and she had a follow-up TTE with bubble study to confirm the closure 90 days later.

Dhoble说：“关闭PFO是确保她能够继续追求自己的激情的唯一方法，所以我很高兴我能够为她做到这一点。”

After Wolbrecht's procedure, she was excited to get back into the water, but COVID-19 put a hold on those plans.

“在2021年5月，我终于能够进行潜水旅行来测试我的PFO。我进行了多次潜水，到达超过100英尺的深度，没有不良影响 - 没有皮肤弯曲，肌肉酸痛，头晕或不安全腿，”她说。

由于PFO是如此普遍，因此沃尔布雷希特（Wolbrecht）希望确保任何潜水员都知道避免潜在严重并发症的情况，并继续潜水。DC的严重形式可能会威胁生命。

她说：“我终于能够回到做自己喜欢的事情，这全都要归功于Dhoble博士。”

In addition to his UT Physicians cardiology practice, Dhoble sees patients in a heart-brain clinic, a multidisciplinary setting where he andAnjail Sharrief，医学博士，MPH，在患者可能患有心脏和神经系统症状的PFO等病例上合作。Sharrief是McGovern医学院神经病学系的副教授，他看到患者UTHealth神经科学诊所。

Dhoble said that PFO raises the risk of stroke since blood, including clots, can pass from one atrium to the other without going through the lungs. "If there is a clot in the blood, it can travel to the brain and cause a stroke," he said.

Dhoble鼓励任何患有非特异性症状的人，例如虚弱或麻木，视力问题或语音障碍，看医生。是否可以排除症状是否与PFO相关，如果连接症状，则可以关闭PFO。心脑诊所每月在位于6410范宁的Uthealth Science Center专业大楼举行一次。要联系诊所，请致电713-500-8828或电子邮件heart@uth.tmc.edu.

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