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\begin{document}

\title{Right cardiac chambers echo-bubble contrast in a patient with
decompression sickness: A case report and a literature revie}



\author[1]{Allam Harfoush}%
\author[1]{Mohammad Ramadan}%
\author[1]{Hanady Hamdallah}%
\affil[1]{Affiliation not available}%


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  \date{May 10, 2024}


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\begin{abstract}
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.%
\end{abstract}%



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