Igor Barković1,2,3,4, Vitomir Maričić5, Boris Reinić3, Frano Marinelli1,2,3, Tamara Turk Wensveen6. 1. Center for Research and Education in Underwater, Hyperbaric and Maritime Medicine, University of Rijeka, Faculty of Medicine, Rijeka, Croatia. 2. Department of Pulmonology, Clinic for Internal Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia. 3. Department for Underwater and Hyperbaric medicine, Clinical Medical Center Rijeka, Rijeka, Croatia. 4. Associate Professor Dr. Sc. Igor Barković, dr. med. Tome Strižića 3, 51000 Rijeka, Croatia, igor.barkovic@uniri.hr. 5. AIDA - International Association for the Development of Apnea, Croatia. 6. Specialized Hospital for Medical Rehabilitation of Cardiac, Pulmonary and Rheumatic Diseases, Thalassotherapia Opatija, Opatija, Croatia.
Abstract
INTRODUCTION: The aim of reporting these two cases is to present visual evidence by bronchoscopy of the origin of haemoptysis in two elite breath-hold divers. CASE REPORTS: Two male elite breath-hold divers of similar physical characteristics presented to our clinic after performing dives of up to 75 and 59 meters of seawater depth for 2:30 and 2:35 (minutes:seconds) respectively. Both patients presented with haemoptysis. Lung ultrasound was performed. The first patient had crackles on chest auscultation, overt pulmonary oedema clinically and 90 ultrasound lung comets. The second patient had no oedema or crackles, but presented with 20 ultrasound lung comets. Video bronchoscopy was performed which showed traces of blood coming from all three segments of the right upper lobe in both patients. The rest of the airways and lungs were intact. CONCLUSIONS: These finding suggest that the apical parts of the lungs are the most prone to deep-dive induced damage. The precise mechanism of lung barotrauma and haemoptysis in breath-hold divers remains to be elucidated. These findings may be of importance for a better understanding of the underlying pathology of haemoptysis. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: The aim of reporting these two cases is to present visual evidence by bronchoscopy of the origin of haemoptysis in two elite breath-hold divers. CASE REPORTS: Two male elite breath-hold divers of similar physical characteristics presented to our clinic after performing dives of up to 75 and 59 meters of seawater depth for 2:30 and 2:35 (minutes:seconds) respectively. Both patients presented with haemoptysis. Lung ultrasound was performed. The first patient had crackles on chest auscultation, overt pulmonary oedema clinically and 90 ultrasound lung comets. The second patient had no oedema or crackles, but presented with 20 ultrasound lung comets. Video bronchoscopy was performed which showed traces of blood coming from all three segments of the right upper lobe in both patients. The rest of the airways and lungs were intact. CONCLUSIONS: These finding suggest that the apical parts of the lungs are the most prone to deep-dive induced damage. The precise mechanism of lung barotrauma and haemoptysis in breath-hold divers remains to be elucidated. These findings may be of importance for a better understanding of the underlying pathology of haemoptysis. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Entities:
Keywords:
Bronchoscopy; Case reports; Freediving; Hemoptysis; Pulmonary barotrauma; Pulmonary oedema