INTRAALVEOLAR HEMORRHAGE AN UNUSUAL PATHO LOGY IN A BREATH-HOLD DIVER

To date, pulmonary oedema in breath hold divers has only been reported after dives below 50 meters, hypoxaemic syncope being the most common risk We recently observed a 35-year-old well-trained breath hold dive r who was unable to achieve deep inspiration during a high-level compe tition, After two hours of repeated dives to a depth of 25 meters for approximately 2-minute periods with intermittent recovery the patient developed cough and haemoptysis. The chest X-ray revealed lung images suggestive of intra-alveolar haemorrhage, The patient had taken 1 g of aspirin per os for three days prior to diving, Symptoms subsided spon taneously in 48 hours and one month later all haematology tests were n ormal except for minimal alteration of platelet aggregation. Pulmonary oedema in breath hold divers is usually atributed to blood shift to t he pulmonary circulation related to the lowered intra-thoracic pressur e, In our case, oedema was secondary to intra-alveolar haemorrhage fav oured by aspirin which should be avoided before breath hold diving.