The classic conditions associated with air embolism during air travel:
(1) bronchogenic cyst
(2) large pulmonary bulla
Additional conditions to consider:
(1) air evacuation with central venous catheter
(2) blunt or penetrating trauma to the lung
(3) in a woman during sexual intercourse (Mile High Club)
Manifestations:
(1) sudden onset of chest pain
(2) sudden episode of coughing and/or gasping
(3) dyspnea and/or cyanosis
(4) tachycardia or bradycardia
(5) with paradoxical embolism to the brain: seizures or coma
Doppler ultrasonography is helpful for identifying air emboli within the right heart and lungs. CT scan can demonstrate air emboli in the brain. A chest X-ray should be performed in order to detect intra-pulmonary pathology.
Differential diagnosis:
(1) venous thromboembolism
(2) scuba diver flying too soon after a dive
(3) acute coronary syndrome
