Scuba diving, acute left anterior descending artery occlusion and normal ECG

BMJ Case Rep. 2013 Jan 31:2013:bcr2012008451. doi: 10.1136/bcr-2012-008451.

Abstract

We report the case of an acute proximal occlusion of the left anterior descending coronary (LAD) artery following a scuba diving decompression accident and associated with normal ECG. Following uneventful thromboaspiration and coronary stenting, the patient was discharged on day 4 with secondary preventative therapies. A transthoracic echocardiography performed at this point showed a complete recovery compared with an initial localised akinesia involving the anterior and apical portion of the left ventricle upon admission. This case highlights that significant acute coronary lesions involving the LAD can occur without any ECG anomaly. The presence of acute and persistent angina associated with troponin elevation should prompt physicians to consider coronary angiography without delay, independently of the ECG results.

Publication types

  • Case Reports

MeSH terms

  • Chest Pain / etiology
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnosis*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / physiopathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology
  • Decompression Sickness / complications
  • Decompression Sickness / diagnosis*
  • Diving / adverse effects*
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Stents
  • Thrombectomy