Atrial septal defect: a coincidental finding on a screening medical.

An otherwise fit, healthy medical practitioner who was a recreational diver underwent a medical assessment for a remote posting as an Antarctic Medical Practitioner at which a coincidental finding of an atrial septal defect (ASD) was made. ASDs can have health implications in extreme environments such as high altitude and is contraindicated in scuba diving. ASDs are common, being present in 1:1,500 live births and comprise 10% of all cardiac abnormalities. In this case, a percutaneous occlusive device was inserted under general anaesthetic with subsequent improvements in the practitioner's exercise capacity, return to diving and full employment, including Antarctic deployment, and right-sided heart remodelling 18 months post closure.