Chest and neck pain underwater

[MollyMiller]

Hi guys,
I’ve been certified since October and have logged about 20 dives. I spent last week in Utila, and I’m currently in Roatan.
I’ve loved every minute of diving, but I’m getting some weird pains.
On my last two dives ( 80 ft max, 35 foot avg) I started having a dull ache in the center of my sternum. Both times it started about halfway through the dive and lasted until surfacing, or faded within 5 minutes of being on the boat. I didn’t notice any changes in pain intensity with depth change. The first time this happened was after not diving for 3 days, so I don’t suspect DCS.

There is also this aching pain in the right side of my neck that I noticed on a few of my dives in Utila, it would happen for the first 5 minutes of the dive as I was descending and then fade away. On Roatan, I got the same pain in conjunction with the chest pain, at the end of the dive rather than the beginning. I’m also having trouble equalizing my right ear. When I surfaced my neck was still hurting so I was feeling around the area and felt a sharp stabbing pain, very intense, when I touched a small spot behind my right ear. That was yesterday morning, the ache is long gone but I can still touch that spot and produce a really sharp pain.

Now the weird part: I took a day off from scuba but did some snorkeling with very shallow freediving. 20 or 30 minutes into yesterday’s snorkel, I got the same chest pain and it lasted till I got out of the water maybe 30 minutes later, with brief moments of relief. I also felt the same neck pain as before when I tried to dive down, but it went away when I equalized. Today’s snorkel was fine, no pains to speak of.

Any ideas what is going on? I suspect the neck pain might be related to the ear problem. As for the chest, I don’t know, maybe I’m breathing wrong or I’m just cold. The water is 80 degrees but I’ve been shivering through my 3mm. Should I be concerned?

 

[Robert H. Diver]

Eat anything weird? Are you hydrated? Sick? Contact DAN and ask.

 

[TheRealScubaSteve]

Talk to DAN first to rule out immediate concerns, then wait for a more helpful response.

 

[Duke Dive Medicine]

Hi guys,
I’ve been certified since October and have logged about 20 dives. I spent last week in Utila, and I’m currently in Roatan.
I’ve loved every minute of diving, but I’m getting some weird pains.
On my last two dives ( 80 ft max, 35 foot avg) I started having a dull ache in the center of my sternum. Both times it started about halfway through the dive and lasted until surfacing, or faded within 5 minutes of being on the boat. I didn’t notice any changes in pain intensity with depth change. The first time this happened was after not diving for 3 days, so I don’t suspect DCS.

There is also this aching pain in the right side of my neck that I noticed on a few of my dives in Utila, it would happen for the first 5 minutes of the dive as I was descending and then fade away. On Roatan, I got the same pain in conjunction with the chest pain, at the end of the dive rather than the beginning. I’m also having trouble equalizing my right ear. When I surfaced my neck was still hurting so I was feeling around the area and felt a sharp stabbing pain, very intense, when I touched a small spot behind my right ear. That was yesterday morning, the ache is long gone but I can still touch that spot and produce a really sharp pain.

Now the weird part: I took a day off from scuba but did some snorkeling with very shallow freediving. 20 or 30 minutes into yesterday’s snorkel, I got the same chest pain and it lasted till I got out of the water maybe 30 minutes later, with brief moments of relief. I also felt the same neck pain as before when I tried to dive down, but it went away when I equalized. Today’s snorkel was fine, no pains to speak of.

Any ideas what is going on? I suspect the neck pain might be related to the ear problem. As for the chest, I don’t know, maybe I’m breathing wrong or I’m just cold. The water is 80 degrees but I’ve been shivering through my 3mm. Should I be concerned?

@MollyMiller , this could be a lot of things, some benign, some not so much. Not knowing anything else about you like age, medical history, etc, an ache in the chest with exertion and immersion is concerning to me from a cardiac standpoint. Your heart is placed under additional load under water due to the redistribution of your blood, so worst case scenario, diving and snorkeling could be aggravating an underlying cardiac condition. The ear pain sounds like middle ear barotrauma, and if the neck pain goes away with equalization then it's likely related to that.

I would recommend not diving until the chest pain question is answered, and getting a medical workup as soon as possible. If you're a native of Gainsville you are lucky enough to have the Shands Undersea and Hyperbaric Medical clinic in town.

Best regards,
DDM

 

[MollyMiller]

Eat anything weird? Are you hydrated? Sick? Contact DAN and ask.

I have had some stomach sickness on this trip, but nothing awful. I’ve been drinking plenty of water, don’t think I’m dehydrated or at least not severely.
I plan to talk to DAN today.

 

[MollyMiller]

@MollyMiller , this could be a lot of things, some benign, some not so much. Not knowing anything else about you like age, medical history, etc, an ache in the chest with exertion and immersion is concerning to me from a cardiac standpoint. Your heart is placed under additional load under water due to the redistribution of your blood, so worst case scenario, diving and snorkeling could be aggravating an underlying cardiac condition. The ear pain sounds like middle ear barotrauma, and if the neck pain goes away with equalization then it's likely related to that.

I would recommend not diving until the chest pain question is answered, and getting a medical workup as soon as possible. If you're a native of Gainsville you are lucky enough to have the Shands Undersea and Hyperbaric Medical clinic in town.

Best regards,
DDM

Thank you DDM,
I’m 22, not overweight, with no heart conditions I’m aware of or any other serious medical conditions. I lead a fairly active lifestyle and consider myself fit. I’ve never felt this sort of pain before with physical exertion.

My equalizing is normal for most of the dive only having a little trouble later in the dive when re-descending after coming up in the shallow reefs around 20 feet. Still can equalize then, just squeaky sometimes. Do you think diving again would worsen the barotrauma?

Thanks for the tip about the Gainesville clinic, I’ll pay them a visit when I get back.
st squeaky sometimes. Do you think diving again would worsen the barotrauma?

@MollyMiller , this could be a lot of things, some benign, some not so much. Not knowing anything else about you like age, medical history, etc, an ache in the chest with exertion and immersion is concerning to me from a cardiac standpoint. Your heart is placed under additional load under water due to the redistribution of your blood, so worst case scenario, diving and snorkeling could be aggravating an underlying cardiac condition. The ear pain sounds like middle ear barotrauma, and if the neck pain goes away with equalization then it's likely related to that.

I would recommend not diving until the chest pain question is answered, and getting a medical workup as soon as possible. If you're a native of Gainsville you are lucky enough to have the Shands Undersea and Hyperbaric Medical clinic in town.

Best regards,
DDM

Thank you DDM,
I’m 22, not overweight, with no heart conditions I’m aware of or any other serious medical conditions. I lead a fairly active lifestyle and consider myself fit. I’ve never felt this sort of pain before with physical exertion.

My equalizing is normal for most of the dive only having a little trouble later in the dive when re-descending after coming up in the shallow reefs around 20 feet. Still can equalize then, just squeaky sometimes. Is diving again out of the question?

Thanks for the tip about the Gainesville clinic, I’ll pay them a visit when I get back.

 

[Duke Dive Medicine]

Thank you DDM,
I’m 22, not overweight, with no heart conditions I’m aware of or any other serious medical conditions. I lead a fairly active lifestyle and consider myself fit. I’ve never felt this sort of pain before with physical exertion.

My equalizing is normal for most of the dive only having a little trouble later in the dive when re-descending after coming up in the shallow reefs around 20 feet. Still can equalize then, just squeaky sometimes. Is diving again out of the question?

Thanks for the tip about the Gainesville clinic, I’ll pay them a visit when I get back.

Hi @MollyMiller ,

Thanks for the additional information; your age and physical condition would place a cardiac issue lower on the differential but in the absence of a clinical evaluation it can't be ruled out. Of course this could also be something relatively benign like reflux, but differential diagnosis over the internet and without an in-person evaluation by a qualified clinician is not possible. This makes it difficult to provide anything but very conservative recommendations for diving again until you find out what's going on.

Best regards,
DDM

 

[Alaskan Scuba Dude]

Could be a mild case of heartburn. Do some stretching just before diving. Use an anti-bacterial solution for Swimmer's ear after and before a dive.

 

[mbs]

Many years back I got a really bad case of reflux diving. Really intense chest pain! Adjusted what I eat before diving and try not go fully inverted as well. But as other say get yourself checked.

 

[MollyMiller]

Thanks everyone! I contacted DAN last week, they agreed the ear problem is most likely mild barotrauma. They didn't know what might be causing the chest pain except maybe reflux as others have said, and advised me not to dive again for a while. I did go snorkeling again and stayed on the surface with no recurrence of pain. I got back to the states a couple days ago, was fine on the plane, no worrying symptoms since then.