Divers face a unique set of underwater hazards in addition to the general aquatic problems such as drowning, hypothermia, water-borne infectious diseases, and interactions with hazardous marine life. Unlike SCUBA diving, breath-hold divers do not use supplemental air underwater. Our patient and his friends were freediving, or breath-hold diving. Spearfishing may be done while freediving, snorkeling or SCUBA diving. He was discharged home on hospital day #2. The patient remained hemodynamically stable and without respiratory distress throughout his hospitalization. Given the patient’s chest pain and subjective shortness of breath, a chest x-ray was performed. The patient had no further hemoptysis after arrival to the emergency department. On exam, he was comfortable and his lungs were clear to auscultation bilaterally. He did not complain of any headache, visual changes, ear pain, nausea, joint or muscle pain, or any other symptoms. On arrival to the emergency department, the patient was breathing comfortably on room air. After returning to his boat, the patient was still experiencing cough, pleuritic chest pain, and mild shortness of breath. After feeling a bit better, he went down again to a depth of 30 feet in order to catch a large fish. After getting onto the boat, the patient coughed up approximately 5 tablespoons of bright red blood. On the way to the surface, he developed chest pain. The patient had dove to a depth of 50 feet using 11 lbs of weights on his belt, holding his breath along the way. The patient had been spearfishing when his symptoms began. A 24-year-old male presented to the Emergency Department with cough and hemoptysis.
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