Diving is my passion. I have been diving over 40 years, am a 66 year old female in excellent shape. On a recent dive I had was unable to breathe when I surfaced from a 65 max depth dive. My dive profile was safe and I felt great the entire dive, until surfacing. Thankfully my buddy was with me. Since it was a drift dive, we had to wait for the boat to find us, give them the distress call, and I was assisted onto the boat. For about 30 minutes I still felt I couldn't get enough air and I was coughing. As time passed, I felt much better; just shaken up. As soon as I got home, I called DAN and they urged me to go to the emergency room because it sounded like possibly pulmonary edema. I did, and ended up admitted for 3 days. Turns out I do have IPE.
Currently I am going though multiple medical tests to try to determine the cause. Apparently, usually more than one thing brings this on. I would love to hear from anyone who has had a similar experience. Additionally, any information about IPE would be appreciated.
@Marciadive , first, I'm sorry to hear this happened and very glad you received prompt help and a diagnosis. Was there anything different about this dive, specifically related to level of exercise and water temperature? Are you a triathlete? If so, how long have you been training?
Also, just so it's asked, was your regulator functioning properly? You mentioned that you felt great for the entire dive so I imagine so but asking to consider/rule out negative pressure pulmonary edema.
Causes of IPE run on a spectrum. Underlying the entire spectrum is the fact that with immersion, the effect of gravity on the fluids in the body disappears, which results in a net increase of blood in the vessels in the torso. Cold water exacerbates this by further shunting blood from the extremities into the torso.
On one extreme end of the spectrum are the triathletes and combat swimmers with exceptionally high cardiac output during exercise, combined with a (likely genetic) predisposition in which the pulmonary arteries do not dilate enough to accommodate the additional blood flow with that cardiac output, which results in pulmonary hypertension (high blood pressure in the pulmonary arteries) and subsequent pulmonary edema during heavy exercise in the water, again exacerbated by cold.
On the other extreme end are people with profound left heart failure who are so affected by immersion that additional blood that shifts into the torso could cause pulmonary edema. Most of those people are not able to dive.
A lot of IPE cases are likely a mix of these: an underlying predisposition for IPE, cold water, heavy exercise, and possibly subclinical cardiac conditions that probably wouldn't declare themselves outside of swimming or diving.
Hopefully a cardiac workup, possibly including ultrasound and stress testing, is part of your plan of care. That would help rule out cardiac causes. Beyond that, people who have experienced IPE are very likely to experience it again, as other posters have noted.
The hyperbaric unit at the Massachusetts Eye and Ear Infirmary has physicians who are trained and experienced in evaluating divers. If you haven't been in touch with them already, I'd recommend you do so. Will DM contact info.
Best regards,
DDM
