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Right cardiac chambers echo-bubble contrast in a patient with decompression sickness: A case report and a literature revie
  • Allam Harfoush,
  • Mohammad Ramadan,
  • Hanady Hamdallah
Allam Harfoush

Corresponding Author:allamharf@gmail.com

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Mohammad Ramadan
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Hanady Hamdallah


The diagnosis of decompression sickness (DCS) is mostly based on clinical suspicion, and there is currently no available modality to fully confirm the diagnosis. However, the use of echocardiography in suspected DCS cases has become more common. In this case, transthoracic echocardiography (TTE) was used to detect microbubbles in the right cardiac chambers and monitor the patient after hyperbaric oxygen therapy (HBOT), suggesting the possible applicability of TTE in diagnosing and monitoring DCS patients. This report describes a 54-year-old Fisherman who was referred to the emergency department with dyspnea and mild confusion after a rapid ascent of a saturation dive at 50 m sea depth. After the initial evaluation, he was assessed using TTE to exclude the presence of structural heart disease, where it surprisingly showed spontaneous echo contrast inside the right cardiac chambers similar to agitated saline echo testing. The patient was then admitted for HBOT and follow-up; rapid improvement was noticed after the first HBOT session and the TTE findings were fully resolved. TTE could be considered in the initial workup when DCS is suspected, and it might have a role in monitoring DCS patients if echocardiographic findings of bubble formation were documented in the pre-hyperbaric therapy settings.
17 Oct 2020Submitted to Clinical Case Reports
26 Oct 2020Submission Checks Completed
26 Oct 2020Assigned to Editor
11 Nov 2020Reviewer(s) Assigned
19 Nov 2020Review(s) Completed, Editorial Evaluation Pending
21 Nov 2020Editorial Decision: Revise Minor
19 Dec 20201st Revision Received
21 Dec 2020Submission Checks Completed
21 Dec 2020Assigned to Editor
21 Dec 2020Review(s) Completed, Editorial Evaluation Pending
22 Dec 2020Reviewer(s) Assigned
29 Dec 2020Editorial Decision: Revise Minor
23 Nov 20212nd Revision Received
13 Dec 2021Submission Checks Completed
13 Dec 2021Assigned to Editor
13 Dec 2021Review(s) Completed, Editorial Evaluation Pending
05 Jan 2022Reviewer(s) Assigned
21 Jan 2022Editorial Decision: Revise Minor
21 Jan 20223rd Revision Received
24 Jan 2022Assigned to Editor
24 Jan 2022Submission Checks Completed
24 Jan 2022Review(s) Completed, Editorial Evaluation Pending
06 Feb 2022Editorial Decision: Accept
Apr 2022Published in Clinical Case Reports volume 10 issue 4. 10.1002/ccr3.5706