ABSTRACT
The practice of recreational scuba diving has increased worldwide, with millions of people taking part each year. The aquatic environment is a hostile setting that requires human physiology to adapt by undergoing a series of changes that stress the body. Therefore, physical fitness and control of cardiovascular risk factors are essential for practicing this sport. Medical assessment is not mandatory before participating in this sport and is only required when recommended by a health questionnaire designed for this purpose. However, due to the significance of cardiovascular disease, cardiology consultations are becoming more frequent. The aim of the present consensus document is to describe the cardiovascular physiological changes that occur during diving, focusing on related cardiovascular diseases, their management, and follow-up recommendations. The assessment and follow-up of individuals who practice diving with previous cardiovascular disease are also discussed. This document, endorsed by the Clinical Cardiology Association of the Spanish Society of Cardiology (SEC) and the SEC Working Group on Sports Cardiology of the Association of Preventive Cardiology, aims to assist both cardiologists in evaluating patients, as well as other specialists responsible for assessing individuals' fitness for diving practice.
Subject(s)
Cardiology , Cardiovascular Diseases , Diving , Humans , Diving/adverse effects , Diving/physiology , Cardiovascular Diseases/therapy , Cardiovascular Diseases/prevention & control , Societies, Medical , Consensus , Spain , Sports Medicine/methods , Sports Medicine/standards , Recreation/physiologyABSTRACT
Central nervous system involvement related to decompression sickness (DCS) is a very rare complication of breath-hold diving. So far, it has been postulated that repeated dives with short surface intervals represent a key factor in the development of breath-holding-related DCS. We report the case of a breath-hold diver who, after repeated immersion, developed DCS with brain involvement. After treatment in a hyperbaric chamber, there was a clinical improvement in the symptoms. Magnetic resonance imaging of the brain showed hyperintense lesions in long-time repetition sequences (FLAIR, T2WI) in the left frontal and right temporal lobes. Diffusion-weighted imaging (DWI) sequences and the apparent diffusion coefficient (ADC) map were characteristic of vasogenic edema, allowing us to exclude the ischemic nature of the process. These findings, together with the acute clinical presentation, the resolution of lesions in evolutionary radiological controls and the possible involvement of blood-brain barrier/endothelial dysfunction in DCS, could suggest a new form of posterior reversible encephalopathy syndrome (PRES)-like presentation of DCS. This would represent a novel mechanism to explain the pathophysiology of this entity. We conducted a literature review, analyzing the pathophysiological and neuroimaging characteristics of DCS in breath-hold diving based on a case of this rare disease.
Subject(s)
Decompression Sickness , Diving , Posterior Leukoencephalopathy Syndrome , Brain/diagnostic imaging , Decompression Sickness/complications , Decompression Sickness/diagnostic imaging , Diving/adverse effects , Diving/physiology , Humans , Neuroimaging/adverse effects , Posterior Leukoencephalopathy Syndrome/complications , Posterior Leukoencephalopathy Syndrome/diagnosis , Posterior Leukoencephalopathy Syndrome/pathologyABSTRACT
El síndrome de Brugada se caracteriza por presentar un ECG típico y presentar cuadros de muerte súbita asociada con arritmias cardiacas. Los candidatos con síndrome de Brugada suelen ser considerados no aptos para la práctica del buceo debido al riesgo de muerte súbita. Actualmente disponemos de información científica que nos puede ayudar a clasificar a estos pacientes en diferentes grupos de riesgo. Presentamos el caso clínico de un varón de 38 años con dos episodios sincopales hace 10 años, diagnosticado de síndrome de Brugada de bajo riesgo que consulta para valorar su aptitud para el buceo
Brugada syndrome is a condition associated with a charasteristic ECG and sudden arrythmic death. Due to the risk of sudden death patients with Brugada syndrome could be considered not fit to dive. In recent years we have gained new insight into this condition and Brugada syndromes patients can be classified into different risk categories. We discuss this issue with a 38 year-old-male with syncopal symptoms 10 year ago. He was diagnosed with a low risk Brugada syndrome who applied for a diving medical certificate
Subject(s)
Humans , Male , Adult , Brugada Syndrome/epidemiology , Brugada Syndrome/physiopathology , Diving/adverse effects , Diving/standards , Risk Factors , Syncope/complications , Syncope/epidemiology , Death, Sudden/epidemiology , Death, Sudden/prevention & controlABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Diving/physiology , Bundle-Branch Block/diagnosis , Cardiovascular Physiological Phenomena , Mass Screening , Physical Conditioning, Human/physiologyABSTRACT
El barotrauma pulmonar representa la segunda causa de muerte en el buceo. Este cuadro suele presentarse durante la respiración de aire a presión ya sea desde unas botellas durante la práctica del buceo o desde un compartimento o habitáculo cerrado donde se intenta igualar la presión del interior con la presión existente en el exterior, esta situación se produce durante los ejercicios de escape libre ya sea desde el denominado tanque de escape o desde un submarino. La consecuencia más grave del barotrauma pulmonar es el embolismo arterial gaseoso situación clínica de alto riesgo vital y que su único tratamiento efectivo es la recompresion en una camara hiperbárica (AU)
