Acute aortic dissection during scuba diving New!
Youichi Yanagawa MD, PhD; Hiromichi Ohsaka MD, PhD; Shoichiro Yatsu MD, PhD; Satoru Suwa MD, PhD
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University Department of Cardiology, Shizuoka Hospital, Juntendo University
CORRESPONDING AUTHOR: Youichi Yanagawa – yyanaga@juntendo.ac.jp
ABSTRACT
Yanagawa Y, Ohsaka H, Yatsu S, Suwa, S. Acute aortic dissection during scuba diving. Undersea Hyperb Med. 2024 Second Quarter; 51(2):185-187.
A 60-year-old man with hypertension and dyslipidemia complained of chest pain upon ascending from a maximum depth of 27 meters while diving. After reaching the shore, his chest pain persisted, and he called an ambulance. When a physician checked him on the doctor’s helicopter, his electrocardiogram (ECG) was normal, and there were no bubbles in his inferior vena cava or heart on a portable ultrasound examination. The physician still suspected that he had acute coronary syndrome instead
of decompression illness; therefore, he was transported to our hospital. After arrival at the hospital, standard cardiac echography showed a flap in the ascending aorta. Immediate enhanced computed tomography revealed Stanford type A aortic dissection. The patient obtained a survival outcome after emergency surgery. To our knowledge, this is the first reported case of aortic dissection potentially associated with scuba diving. It highlights the importance of considering aortic dissection in patients with sudden-onset chest pain during physical activity. In addition, this serves as a reminder that symptoms during scuba diving are not always related to decompression. This report also suggests
the usefulness of on-site ultrasound for the differential diagnosis of decompression sickness from endogenous diseases that induce chest pain. Further clinical studies of this management approach are warranted.
Keywords: aortic dissection; scuba diving; ultrasound
10.22462/688