Cerebral and coronary gas embolism from the inhalation of pressurized helium.
OBJECTIVE
Inhalation of helium, which produces a change in the voice, is frequently used among young rock singers to improve their performance.


METHODS
A case report.


METHODS
Adult medical intensive care unit in a university hospital.


METHODS
A 23-yr-old singer, who accidentally inhaled helium from a high pressurized tank without pressure reduction, presented with transient loss of consciousness and chest pain.


METHODS
Electrocardiogram, chest radiograph, biochemical and toxicological analyses, echocardiography, coronary angiography were performed.


RESULTS
At admission, the patient slowly regained consciousness. An electrocardiogram showed significant ST elevations in leads I, aVL, and V4-V6. The chest radiograph was consistent with pulmonary congestion and pneumomediastinum. The echocardiogram showed normal sized heart chambers with hypokinesis of the left ventricular lateral wall. Ethanol and urine cannabinoids were present in low concentrations, but no presence of opiates, methadone, cocaine, or amphetamines was documented. Troponin T was positive. Elevation of ST segments gradually disappeared within 30 mins, the drowsiness within 10 hrs, and the thoracic pain within 24 hrs. Coronary angiography showed normal coronary arteries. The patient was discharged on day 3 without any symptoms and with normal electrocardiogram and chest radiograph.


CONCLUSIONS
Accidental inhalation of helium under high pressure can cause symptomatic cerebral and coronary artery gas embolism.
Tretjak
Martin
M
Center for Intensive Internal Medicine, University Medical Center Ljubljana, Slovenia.
Gorjup
Vojka
V
Mozina
Hugon
H
Horvat
Matija
M
Noc
Marko
M
D000059:Accidents; D000280:Administration, Inhalation; D000328:Adult; D002561:Cerebrovascular Disorders / Q000139:chemically induced* / Q000175:diagnosis; D017023:Coronary Angiography; D003327:Coronary Disease / Q000139:chemically induced* / Q000175:diagnosis; D004452:Echocardiography; D004562:Electrocardiography; D004618:Embolism, Air / Q000139:chemically induced* / Q000175:diagnosis; D006371:Helium / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011312:Pressure; D013902:Radiography, Thoracic; D014831:Voice
D006371:Helium