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Decompression illness (DCI) occurs when dissolved nitrogen forms bubbles in a diver's vasculature due to pressure changes during ascent. According to one theory, patent foramen ovale (PFO) contributes to DCI by allowing venous nitrogen bubbles to enter the arterial system. To examine a possible association between PFO and DCI, 100 experienced divers were surveyed about self-reported DCI episodes during a mean follow-up of nearly 2.5 years. At baseline, participants underwent transthoracic and transesophageal echocardiogram (with bubble studies and Valsalva maneuver) to assess presence and grade of PFO; high-risk PFO was defined as shunting prior to Valsalva, larger PFO size (≥2 mm), hypermobility, or septal aneurysm. Divers were blinded to …