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Takotsubo cardiomyopathy associated with diving
Hichem Chenaitia1, Matthieu Coullange, Lionel Benhamou
1Department of Emergency, Marseille's University Hospital, France. chenaitiahichem@hotmail.fr
Summary
Takotsubo cardiomyopathy, a stress-induced heart condition, can occur during diving. This case highlights the potential for this cardiac syndrome to be triggered by the physical and emotional stress of deep-sea diving.
Area of Science:
- Cardiology
- Emergency Medicine
- Diving Medicine
Background:
- Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular dysfunction without coronary artery disease.
- It is typically triggered by emotional or physical stress.
Observation:
- A 51-year-old woman presented with chest pain and dyspnea after deep diving.
- She experienced chest tightness and dyspnea during ascent under emotional stress.
- ECG showed inverted T-waves, chest X-rays revealed lung infiltrates and a globular heart.
Findings:
- Elevated cardiac enzymes (troponin Ic, myoglobin, CK) and N-terminal prohormone brain natriuretic peptide.
- Echocardiography showed apical ballooning and reduced ejection fraction (35%).
- Coronary angiography confirmed healthy coronary arteries, ruling out obstructive coronary disease.
Implications:
- This case suggests that Takotsubo cardiomyopathy can be precipitated by the stressors associated with deep diving.
- It underscores the importance of considering TTC in patients presenting with cardiac symptoms after diving.
- Further research may be needed to understand the specific mechanisms linking diving and TTC.
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