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Went For Fishing And Body Was Fond Floating. Noticed Blood From Nose, Ears And Even Mouth. Is Heart Attack Cause For The Death?

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Posted on Mon, 2 Sep 2013
Question: Hi,

On Monday morning one of my cousins went out spear fishing with some friends. He went down around 14-20 feet in the water around 2 times without having a rest and as he came back out on the boat the 2cnd time he complained he didn’t feel well. He must have seen a fish he wanted to get as he seemed very adamant.. Unfortunately the 3rd time he went down a few minutes later his body was seen floating on the surface. His friends said that he had blood coming out of his nose and ears and I believe also froth from his mouth. The post mortem showed that he has a severe heart attack. However a biopsy has been sent to the UK for checking as something does not seem right. What could have caused his death? He was 24 years old and there was no indication of any health problems. He did like the gym and kept fit but did not seem big enough to be taking any steroids or something. My belief is that it could be due to the water pressure however I would like some answers so that I can feel at rest. Please help me.
doctor
Answered by Dr. Sukhvinder Singh (18 hours later)
Dear Ma'm
It's really painful to hear about loss of a young life.
In all probability your cousin suffered a combination of hazards associated with deep diving. These include decompression sickness and barotrauma.
When we go deep in water the pressure of air increases inside the body and as we come out it (air) tends to expand at lower pressures, this can cause trauma to the organ in which it is present. Like it can damage lungs/ ears etc. Second phenomenon is where non-dis-solvable gases like nitrogen produces bubbles in the body, including the blood vessels after coming out of water. This mainly leads to neurological, joint and lung damage, but at times may effect heart. This second mechanism is peculiar to SCUBA divers who use breathing equipment underwater.
There is no specific direct effect on heart but a bubble entrapped into the blood vessel of heart, a low oxygen level and formation of a clot in blood vessel of heart in such conditions may result into a heart attack.
A fatigue of diver or an underwater injury may have contributed to his condition.
Hope this gives some insight. Please feel free to discuss further. I will provide more details for further queries.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (2 days later)
Hi Dr Sukhvinder,

Thank you for your response. I hope that his death was not a painful one.

I have a few questions for myself and i hope that you will be able to answer.

Last year i began suffering from Acid Reflux and i was put on Controloc tablets for a few months. I noticed that after id been taking them for a month i started having arythmia. Although now i do not take them anymore except occasionaly sometimes i wake up during the night and feel my heart is beating out of rythem and i cannot sleep on my left side as its worse. When i turn to my right i cannot feel it. A few years back i had an ECG and my heart was fine. However i would like to know why i get this sometimes. I do notice when i am stressed out it happens. Im worried as i hope it is not XXXXXXX Should i go have a check up?
doctor
Answered by Dr. Sukhvinder Singh (3 hours later)
Brief Answer:
please see the detailed answer below.

Detailed Answer:
Dear Ma'm
1. If you ever had loss of consciousness/ blackout/ unexplained fall/ chest pain associated with these rhythm disturbances, then it is an emergency and you must consult your cardiologist on priority. Else the following paragraphs will give you insight into your problem.
2. First and most important thing in work up in to identify the rhythm by means of acquiring an ECG at the time of episode. If episode is too short lasting , we can get a 24 hours ECG monitoring (holter monitoring). Rest of the things will depend upon the rhythm identified.
3. Most of the transient rhythm disorders of heart are "premature contractions" which we feel as sudden missing of beat, a transient thump on chest or at times a short lasting dizziness. If they are identified on ECG /Holter, next step is to get an ECHO done to rule out a structural heart disease. If it is normal, nothing else is required to be done and patient can be managed by counselling/ single drug. Thyroid hormone testing and hemoglobin is usually checked in such patients.
4. Just get a simple clinical examination from your GP. If he feels that there is something abnormal, only then go for a detailed work-up.
Hope this helps.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

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Went For Fishing And Body Was Fond Floating. Noticed Blood From Nose, Ears And Even Mouth. Is Heart Attack Cause For The Death?

Dear Ma'm
It's really painful to hear about loss of a young life.
In all probability your cousin suffered a combination of hazards associated with deep diving. These include decompression sickness and barotrauma.
When we go deep in water the pressure of air increases inside the body and as we come out it (air) tends to expand at lower pressures, this can cause trauma to the organ in which it is present. Like it can damage lungs/ ears etc. Second phenomenon is where non-dis-solvable gases like nitrogen produces bubbles in the body, including the blood vessels after coming out of water. This mainly leads to neurological, joint and lung damage, but at times may effect heart. This second mechanism is peculiar to SCUBA divers who use breathing equipment underwater.
There is no specific direct effect on heart but a bubble entrapped into the blood vessel of heart, a low oxygen level and formation of a clot in blood vessel of heart in such conditions may result into a heart attack.
A fatigue of diver or an underwater injury may have contributed to his condition.
Hope this gives some insight. Please feel free to discuss further. I will provide more details for further queries.
Sincerely
Sukhvinder Singh