Dive Accident Symptoms Delayed 6 Months?

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(Q) 06.09.11
“Is it possible to suffer any problems from diving 6 months AFTER the dive? I had what I would consider a fairly normal dive experience. We were in Fiji and we dove to a max of 100ft.

We flew home to New Zealand 2 days later. I had a panic attack (had only ever had one before in my life) where I felt like I couldn’t breath about 3 weeks later but that was the only “odd” thing that happened. I’ve since flown to the States and back and when I returned from the States (it was almost 5 months post dive) was when I started noticing severe shortness of breath. (tests at the doc confirmed that I am only using 56% of my lung capacity and that my lungs are “restricted”).

I never mentioned my diving because it never crossed my mind… especially since it was several months before the symptoms came on. I’ve had a lung x-ray and it showed no abnormalities. They haven’t found a cause yet and the shortness of breath and chest tightness seems to be getting worse.

A barium swallow and upper GI found some looping the bowel, but a chest x-ray, physical exam and EKG and exercise stress testing with echo were negative.

Is there ANY chance it could be dive related??”

(A) 06.14.11

“Hi m….,

Given report that there was nothing abnormal in the dives, e.g., uncontrolled ascent, breath holding on ascent, chest discomfort, coughing up blood in the sputum; the first signs or symptoms of any medical problem weren’t until about 3 weeks after the last dive (“panic attack,” not further described); no pulmonary complaints (shortness of breath (SOB)) until about 5 months after the last dive; and a chest x-ray and physical exam that were within normal limits, it appears very unlikely that diving proper is the cause of the current complaints. Lung injuries related to SCUBA typically show signs and symptoms very rapidly.

With spirometry findings that you are “…only using 56% of my lung capacity and that my lungs are ‘restricted’”, one will want to rule out chronic obstructive pulmonary disease (COPD (http://en.wikipedia.org/wiki/COPD).

Second, you may have developed a blockage of one or more arteries in the lungs. This is known as pulmonary embolism (PE) and in most cases is the result of blood clots that travel to the lungs from another body site, most commonly the legs. It is possible to have PE even when a chest x-ray is negative and EKG, cardiac stress and echocardiography tests are within normal limits. With only small emboli, SOB may be the sole symptom. Breathing may become very rapid, especially upon exertion, and there may be related anxiety, a picture resembling the “panic” attack you mention. You might wish to discuss with your physician the wisdom of a high resolution CT scan of the lungs and a procedure often useful in diagnosing PE called a D-dimer (http://en.wikipedia.org/wiki/D-dimer). Other diagnostics, such as pulmonary CT angiography (http://en.wikipedia.org/wiki/CT_pulmonary_angiogram) and extensive blood assays may follow.

Finally, given SOB and a sensation of tightness in the chest that appear to be progressive, a number of possibilities suggest themselves. One is that the dilated loops of bowel imaged following barium swallow may be cause SOB, especially after eating or when sitting. This probably should be further investigated, although it seems a bit of a long shot.

Regards,
DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

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2 comments for “Dive Accident Symptoms Delayed 6 Months?

  1. jeff franks
    July 14, 2011 at 12:11 pm

    hi
    first note: i’m not in the medical field
    however the situation sounds familiar enough that i’ll make two comments
    1) 11 yrs ago i had similar breathing problems and ache in chest. i had all these same tests done and a couple more (and many follow up ekg) but did not have angioscopic assessment of heart arteries at that time. i felt fine for 8 years and then had a massive heart attack. they found 3 arteries 95 to 100% blocked–it’s likely i had major blockage all those years and it wasn’t detected.
    2) since cardiac surgery, i have developed some problems that seem to actually be ‘panic attacks’–constricted breathing, chest ache … and subjectively notice that for periods my breathing is restricted to shallow upper chest respiration and not my normal deep abdominal breathing that developed first through extensive buddhist meditation and later diving

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  2. May 30, 2012 at 11:16 pm

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