Lethal event in diving with self-contained underwater breathing apparatus: A forensic study

Area of Science:

• Forensic Pathology
• Cardiology
• Diving Medicine

Background:

• Differentiating primary drowning from secondary drowning in fatal scuba diving accidents is crucial.
• Water inhalation is often the final event in a complex series of fatal circumstances.
• Pre-existing, low-risk heart conditions can become life-threatening during scuba diving.

Purpose of the Study:

• To investigate the role of cardiovascular diseases in scuba diving fatalities.
• To analyze medicolegal cases of diving deaths over a 20-year period.

Main Methods:

• Case series analysis of 20 years (2000-2020) of scuba diving deaths.
• Judicial autopsies with histological and toxicological investigations.

Main Results:

• Heart failure with acute myocardial infarction due to severe myocardiocoronarosclerosis was identified in four cases.
• One case resulted in primary drowning without prior pathology.
• One case involved terminal atrial fibrillation secondary to acute heart failure.

Conclusions:

• Lethal diving events are frequently associated with unrecognized or subclinical cardiovascular diseases.
• Improved regulatory oversight, considering diving risks and underlying pathologies, could prevent fatalities.
• Screening for cardiovascular conditions may be essential for diver safety.