Detection of venous gas emboli after repetitive breath-hold dives: case report

Introduction: Neurological symptoms after breath-hold (BH) diving are often referred to as “Taravana” and considered a form of decompression sickness. However, the presence of “high” gas embolism after BH diving has never been clearly shown. This study showed high bubble formation after BH diving. Materials and methods: We performed transthoracic echocardiography on a 53-year-old male spearfishing diver (180 cm; 80 kg; BMI 24.7) 15 minutes before diving and at 15-minute intervals for 90 minutes after diving in a 42-meter-deep pool. Number of dives, bottom time and surface intervals were freely determined by the diver. Dive profiles were digitally recorded for depth, time and surface interval, using a freediving computer. Relative surface interval (surface interval/diving time) and gradient factor were calculated. Results: High bubble grades were found in all the recorded echocardiograms. From the first to third recording (45 minutes), Grade 4 Eftedal-Brubakk (EB) bubbles were observed. The 60-, 75- and 90-minute recordings showed a reduction to Grades 3, 2 and 1 EB. Mean calculated GF for every BH dive was 0.22; maximum GF after the last dive was 0.33. Conclusions: High bubble grades can occur in BH diving, as confirmed by echocardiographic investigation. Ordinary methods to predict inert gas super- saturation may not able to predict Taravana cases.This document is the accepted Authors' Copy of the paper published in UHM 2016, 43(4): 449-455. This paper has received funding from the European Union (EU)'s H2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 643712 to the project Green Bubbles RISE for sustainable diving (Green Bubbles). This paper reflects only the authors' view. The Research Executive Agency is not responsible for any use that may be made of the information it contains