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Right cardiac chambers echo‐bubble contrast in a patient with decompression sickness: A case report and a literature review

Harfoush, Allam; Ramadan, Mohammad; Hamdallah, Hanady; (2022) Right cardiac chambers echo‐bubble contrast in a patient with decompression sickness: A case report and a literature review. Clinical Case Reports , 10 (4) , Article e05706. 10.1002/ccr3.5706. Green open access

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Abstract

The diagnosis of decompression sickness (DCS) is mostly based on clinical suspicion, and there is currently no available modality to fully confirm the diagnosis. However, the use of echocardiography in suspected DCS cases has become more common. In this case, transthoracic echocardiography (TTE) was used to detect microbubbles in the right cardiac chambers and monitor the patient after hyperbaric oxygen therapy (HBOT), suggesting the possible applicability of TTE in diagnosing and monitoring DCS patients. This report describes a 54‐year‐old Fisherman who was referred to the emergency department with dyspnea and mild confusion after a rapid ascent of a saturation dive at 50 m sea depth. After the initial evaluation, he was assessed using TTE to exclude the presence of structural heart disease, where it surprisingly showed spontaneous echo contrast inside the right cardiac chambers similar to agitated saline echo testing. The patient was then admitted for HBOT and follow‐up; rapid improvement was noticed after the first HBOT session and the TTE findings were fully resolved. TTE could be considered in the initial workup when DCS is suspected, and it might have a role in monitoring DCS patients if echocardiographic findings of bubble formation were documented in the pre‐hyperbaric therapy settings.

Type: Article
Title: Right cardiac chambers echo‐bubble contrast in a patient with decompression sickness: A case report and a literature review
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ccr3.5706
Publisher version: https://doi.org/10.1002/ccr3.5706
Language: English
Additional information: © 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: DCS, decompression sickness, hyperbaric oxygen therapy, microbubbles, transthoracic echocardiography, TTE
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10214224
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