PFO screening in DCS cases with no obvious risk factors or with high but non-modifiable risk for DCS

After a DCS, primarily prevent bubbles with behavioural and technical (B&T) changes

If B&T changes are not possible or not effective, PFO closure can be proposed with shared decision making underscoring the lack of evidence

Resume unrestricted activity only after confirmed PFO sealing post intervention

Primary PFO screening

Deny conventional flight or diving after incidental finding of PFO

High-risk recreational dives after incidental finding of PFO

Propose PFO closure if B&T changes can be made and are effective