Diving-related pulmonary oedema as an unusual presentation of alcoholic cardiomyopathy.

Diving-related pulmonary oedema (DRPO) is an uncommon and incompletely understood phenomenon. Pulmonary oedema has been rarely documented in shallow water. It is also associated with cold water and exertion and has been seen in swimmers as well as divers with no underlying heart disease. We describe an otherwise well 69-year-old lady who developed diving-related pulmonary oedema on her second and third dives in a shallow, heated pool. Follow-up echocardiogram revealed moderate global left ventricular dysfunction with an ejection fraction of 37%. There was a history of alcohol consumption of half a bottle of wine per day, which combined with the echocardiographic findings led to the diagnosis of alcoholic cardiomyopathy. We believe this not only to be the oldest patient with a documented case of DRPO but also the first report where it has clearly unmasked clinically significant underlying heart disease.