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This sounds like a problem relating to general cardiovascular fitness and not a unique diving problem, like PFO.

Certain illnesses or conditions produce a unique problem for diving --- examples:
PFO (air embolism); asthma (more theoretical than practical); ear problems; sinus problems; dental problems, and so on. These conditions are directly affected by the pressure gradients experienced by divers and the need to breathe pressurized gases.

Other problems, like angina, are not unique to diving but merely reflect the risk of the disease in any athletic endeavor. Granted, a heart attack at 60 feet under is a tad dicier than one in your bedroom, but one can have such an attack driving, or descending a staircase or in any other of a number of situations that are "suboptimal".

If you can swim a mile and a half at a time, your cardiovascular tolerance is better than the average American and should be fine for ordinary recreational diving.

If they won't clear you for diving, ask if they would clear you for the swimming regimen you now pursue. If they allow you to swim long distances, but not to dive, they a) don't understand diving and/or b) are just in the CYA mode as you say.

By its nature, recreational diving should be viewed as a relaxing swim, not as an aerobic conditioning event. Not to say that a diver shouldn't be fit, or that lugging and wearing equipment isn't stressful at times. But someone with ischemic heart disease who can safely pursue vigorous land-based or other non-diving aerobic workouts should be able to dive.

This advice is not meant to supplant the advice of your physician, merely one person's opinion. I would be interested in hearing other medical thoughts...
 
My angiogram indicated that all vessels were clear with no plaques. I am insulin resistant, but my push to lose weight and increase my cardio fitness will correct that (IMHO) I am on 45 mg of Actos and 500 of metformin 2x/day. Blood sugars are well controlled. They had me on a long acting nitrate, that was DCed in January and I have felt better since.

My doc has written papers on this condition, and since he's a diver, I am hoping that he sign off on me. I'll get the angiogram pic for him (My first cardiologist did that).

I just want to be able to dive. I'd willingly limit myself to 60 feet. I am not interested in collecting china from the Andrea Doria. I just want to play!
 
If they didn't pick up anything on angio, then you're probably fine. I'm curious on what basis they diagnosed your bridging if they didn't see anything on angio?

Insulin resistance is a big risk factor for atherosclerotic dz, but it sounds like you're managing that well.

If your doc is into this, then you're probably in good shape. I'm guessing he's not the guy that put you on the nitrate?

Like shakeybrainsurgeon said, this shouldn't pose an inherent risk to diving. As I said above, if you can tolerate exercise to that extent otherwise, you should be in good shape.
 
The new doc is the one who took me off of the isosorb. He didn't say it out right but he kinda nonverbally indicated that the first doc is a schmuck. He also has written papers that my condition is a largely benign issue.

I was diagnosed via angiogram. I was having a little angina ( a lovely present for my 39th birthday!). I got put on the treadmill by my endocrinologist. Result: a 700 dollar bill and a finding of "something but we don't know what". I was referred for a stress thallium. Result: a bill of 1700 and a finding of "something but we don't know what". I had the angiogram that showed the kink in the artery but absolutely clean arteries.

If I don't get passed for diving, the doc is going to have to provide me with no lawn mowing and snow shoveling restrictions too.

If this is a legit issue, I want good medical advice and will follow it. But if it is just cyaing, I am tempted to Dr shop. I won't because I wouldn't want it to reflect on my training LDS, but I will be tempted.
 
Call DAN:
1-919-684-8111, 1-800-446-2671 (toll-free)

From them you can obtain advice on or get a referral to someone about this condition. They may have enough information that your cadiologist could make a determination from your existing testing.

Ask for your doc to review your case, not the nurse/practititioner.

While nobody heard me type this, in the future, if this condition proves benign, you may want to keep it under your hat. If you check off "heart condition" on any release form, then there will be questions and red tape and refusals. They could actually deny diving privileges in far off places like Australia. I want to stress, if the condition isn't going to put you at risk, then it's none of their business.
 
My problem is that I was honest. I went to the hospital where the angiogram was done and gathered all the records, to include a CD of pic from the procedure. I dropped this off at the doc's and haven't heard anything.

I do have a note from my regular doc indicating that I am good to go.

If I don't hear from the cardiologist by Wednesday, I will feel the need to play the second doc's note.
 
Hi SnakeRiverPiliot,

We have a dive medicine savvy cardiologist of a very high caliber who visits the board on occasion. His name is Doug Ebersole and he's quite a helpful chap. Although he practices far from you (FL), he almost surely will respond in detail to an email inquiry. He can be contacted at http://debersole.com/layout/0001/contact_leavemessage.cfm. Feel free to mention that I referred you.

In the meantime, the individual who can sustain 13 METS (Level IV of the standard Bruce protocol) without angina, shortness of breath or EKG abnormality; has an angiogram indicating that all vessels are clear with no plaques and shows no narrowing or compression of the LAD; is otherwise healthy and fit; feels like diving; and, has clearance for scuba from his PCP, seems at minimal increased risk from continuing to dive.

Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

Regards,

DocVikingo
 
The only thing I can add to Doc Vikingo's excellent post is that, if you've had a treadmill, a thallium, and an angio, I can't imagine what additional tests they want to run to evaluate your fitness to dive. Unless the tests you mention are many years old, they should be adequate.
 
My tests were done on in May and June of 2004. If they want a new treadmill, I am cool with that. If 13 METS is the good to go threshold, I went 15 when I did my first treadmill. I know that I could Ranger through the full 14 minutes now with little difficulty. My only argument against the stress thallium is that it was inconclusive last time. Now that I am on the Coreg, it should show nothing. So why not just a normal treadmill?

The records indicated that there was no stenosis. There is minor cardiac bridging of the left anterior artery. Furthermore no one has called me with any further directive.

Screw it I am gonna go diving.
 
gert7to3:
Call DAN:
1-919-684-8111, 1-800-446-2671 (toll-free)

From them you can obtain advice on or get a referral to someone about this condition. They may have enough information that your cadiologist could make a determination from your existing testing.

Ask for your doc to review your case, not the nurse/practititioner.

While nobody heard me type this, in the future, if this condition proves benign, you may want to keep it under your hat. If you check off "heart condition" on any release form, then there will be questions and red tape and refusals. They could actually deny diving privileges in far off places like Australia. I want to stress, if the condition isn't going to put you at risk, then it's none of their business.
I would have your doctor call DAN. He will be able to give more technical information then you can and get a better answer.
 
https://www.shearwater.com/products/perdix-ai/

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