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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
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Affiliation
Tishreen University Hospital; University of Chester
EPub Date
Publication Date
2022-04-14
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Chester Medical School
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Abstract
Background: so far there is no available modality to fully confirm the diagnosis, however, the application of echocardiography in suspected DCS cases has been more frequently used, in this case, transthoracic echocardiography (TTE) was used to detect micro-bubbles in the right cardiac chambers and monitor the patient after hyperbaric oxygen therapy (HBOT); which proposes the possible applicability of TTE in diagnosing and monitoring DCS patients. Case presentation: This report describes a 54-year-old fisherman who was referred to the emergency department with dyspnea and mild confusion after rapid ascend of a saturation diving of 50m sea depth. After the initial evaluation, he was assessed using TTE to exclude the presence of structural heart diseases, where it surprisingly showed spontaneous echo contrast inside the right cardiac chambers similar to agitated saline echo testing, the patient then was admitted for HBOT and follow-up; rapid improvement was noticed after the first HBOT session and the TTE findings were fully resolved. Conclusion: 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 bubbles formation were documented in the pre-hyperbaric therapy settings.
Citation
Harfoush, A., Ramadan, M., & Hamdallah, H. (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), e05706. https://doi.org/10.1002/ccr3.5706
Publisher
Wiley Open Access
Journal
Clinical Case Reports
Research Unit
URI
http://hdl.handle.net/10034/627323
DOI
10.1002/ccr3.5706
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Article
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EISSN
2050-0904
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https://onlinelibrary.wiley.com/doi/10.1002/ccr3.5706