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Breath-hold diving and decompression sickness.

Prof Dr Jochen D Schipke1, Dr Ulrich Limper2, Prof Dr Kay Tetzlaff3

  • 1Research Group Experimental Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.

The American Journal of Medicine
|December 15, 2025
PubMed
Summary
This summary is machine-generated.

Decompression sickness (DCS) is rising in breath-hold diving, often causing neurological symptoms. Early recognition and treatment, including oxygen and hyperbaric therapy, are crucial for affected divers.

Keywords:
Breath-hold divingDecompression sicknessHyperbaric oxygen therapyNeurological symptomsTaravana syndrome

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Area of Science:

  • Diving Medicine
  • Neurology
  • Physiology

Background:

  • Decompression sickness (DCS) is increasingly reported in breath-hold diving, distinct from SCUBA-related cases.
  • Historical Taravana syndrome and modern freediver cases highlight the evolving landscape of DCS.
  • This condition often affects young, healthy individuals, presenting with neurological symptoms.

Purpose of the Study:

  • To review and synthesize cases of DCS in breath-hold diving over 75 years.
  • To identify key risk factors and clinical manifestations specific to breath-hold DCS.
  • To emphasize the need for improved awareness and management strategies.

Main Methods:

  • Comprehensive literature review of 85 records.
  • Analysis of 244+ documented cases spanning 75 years.
  • Synthesis of historical and contemporary data on breath-hold diving DCS.

Main Results:

  • Breath-hold DCS predominantly presents with cerebral symptoms, mimicking stroke.
  • Risk factors include inadequate surface intervals, deep dives (>40m), rapid ascents, and patent foramen ovale.
  • DCS is underrecognized and underreported despite the growing popularity of freediving.

Conclusions:

  • Early recognition of breath-hold DCS requires high clinical suspicion for neurological symptoms in divers.
  • Immediate high-flow oxygen and hyperbaric oxygen therapy are essential treatments.
  • Enhanced education for divers and medical professionals is vital for prevention and management.