Calcium Score and Fitness to Dive

[ljwillia]

Hi -

My husband is 64 and under the care of a cardiologist who has cleared him for diving. He's a type 1 diabetic (diagnosed at 19 yo). He has a calcium score of 1940. He's generally in good shape. His cholesterol and BP are controlled through medication. He has never had chest pains or symptoms of any kind. His Doctor has advised that he should live his life and enjoy whatever activities he likes as long as he is symptom-free. My husband is wondering if he should be evaluated for fitness to dive by a Dr. who has scuba experience, e.g., a DAN doctor.

He doesn't want to give up diving but doesn't want to be foolish or jeopardize his safety and others who dive with him. His GP (who used to dive) has deferred to his cardiologist. As I said, he has confidence in his cardiologist... on land. He's not sure if diving adds an unknown to his breadth of knowledge.

 

[JohnnyQuest]

Maybe not an exact answer, but good info here regarding the cv system and diving.

The Heart & Diving

Maintaining cardiovascular health is an essential component of scuba diving safety. Heart diseases may affect dive fitness.

dan.org

 

[ljwillia]

Maybe not an exact answer, but good info here regarding the cv system and diving.

The Heart & Diving

Maintaining cardiovascular health is an essential component of scuba diving safety. Heart diseases may affect dive fitness.

dan.org

Thank you for sharing the link.

 

[Jersey1971]

I’m a cardiologist but not trained in dive medicine. So this is not medical advice. DukeMD can likely offer real advice.

Has he had a stress test? If it were me, I would want the confidence that I don’t have flow limiting atherosclerosis before engaging in an activity where my survival may depend on my capacity for sustained physical exertion.

That being said, most MI’s occur in vessels with nonobstructive disease. Your husband is at higher risk, based on his calcium score, so I wouldn’t just flippantly say “live your life”. An MI that might be survivable above water may not be at 100 feet.

So a lot depends on personal values. I’m not a daredevil, and if it were me, I’d accept the increased risk and keep diving, given a negative stress test and good exercise capacity. I would limit myself to recreational dives. You do not want a 2 hour decompression obligation while experiencing a MI. But different people might come to different conclusions.

 

[ljwillia]

I’m a cardiologist but not trained in dive medicine. So this is not medical advice. DukeMD can likely offer real advice.

Has he had a stress test? If it were me, I would want the confidence that I don’t have flow limiting atherosclerosis before engaging in an activity where my survival may depend on my capacity for sustained physical exertion.

That being said, most MI’s occur in vessels with nonobstructive disease. Your husband is at higher risk, based on his calcium score, so I wouldn’t just flippantly say “live your life”. An MI that might be survivable above water may not be at 100 feet.

So a lot depends on personal values. I’m not a daredevil, and if it were me, I’d accept the increased risk and keep diving, given a negative stress test and good exercise capacity. I would limit myself to recreational dives. You do not want a 2 hour decompression obligation while experiencing a MI. But different people might come to different conclusions.

Thank you for the insight. His stress test was negative. I'm certainly not looking for medical advice. I'm trying to determine if he should see a dive doctor for a second opinion before making the decision to retire from diving.

We are recreational divers who prefer to stay shallow.

 

[Duke Dive Medicine]

Hi -

My husband is 64 and under the care of a cardiologist who has cleared him for diving. He's a type 1 diabetic (diagnosed at 19 yo). He has a calcium score of 1940. He's generally in good shape. His cholesterol and BP are controlled through medication. He has never had chest pains or symptoms of any kind. His Doctor has advised that he should live his life and enjoy whatever activities he likes as long as he is symptom-free. My husband is wondering if he should be evaluated for fitness to dive by a Dr. who has scuba experience, e.g., a DAN doctor.

He doesn't want to give up diving but doesn't want to be foolish or jeopardize his safety and others who dive with him. His GP (who used to dive) has deferred to his cardiologist. As I said, he has confidence in his cardiologist... on land. He's not sure if diving adds an unknown to his breadth of knowledge.

Hi @ljwillia ,

What was the indication for the coronary calcium score test?

Given the information you've provided, it looks like your husband has multiple risk factors for a cardiac event and I'd strongly recommend he be evaluated by a diving physician. Richmond isn't far from Durham, we're happy to see him in clinic here. The other hyperbaric facility that's reasonably close to you with physicians who can evaluate divers is Shock Trauma in Baltimore. DAN may know someone who's closer to Richmond.

Best regards,
DDM

 

[ljwillia]

Hi @ljwillia ,

What was the indication for the coronary calcium score test?

Given the information you've provided, it looks like your husband has multiple risk factors for a cardiac event and I'd strongly recommend he be evaluated by a diving physician. Richmond isn't far from Durham, we're happy to see him in clinic here. The other hyperbaric facility that's reasonably close to you with physicians who can evaluate divers is Shock Trauma in Baltimore. DAN may know someone who's closer to Richmond.

Best regards,
DDM

His endocrinologist referred him for the test based on the number of years he's been a diabetic, coupled with the medications he takes to control cholesterol and BP. His A1C is generally 6.1 and has been for years. His diabetes is well controlled, but he's been living it with it for 45 years.

I googled the clinic. Unfortunately, your link is down at the moment. Can we just call for an appointment or do we need a referral?

 

[ljwillia]

His endocrinologist referred him for the test based on the number of years he's been a diabetic, coupled with the medications he takes to control cholesterol and BP. His A1C is generally 6.1 and has been for years. His diabetes is well controlled, but he's been living it with it for 45 years.

I googled the clinic. Unfortunately, your link is down at the moment. Can we just call for an appointment or do we need a referral?

His endocrinologist referred him for the test based on the number of years he's been a diabetic, coupled with the medications he takes to control cholesterol and BP. His A1C is generally 6.1 and has been for years. His diabetes is well controlled, but he's been living it with it for 45 years.

I googled the clinic. Unfortunately, your link is down at the moment. Can we just call for an appointment or do we need a referral?

Never mind. Link is back up and I've got the number to call for an appt.

Thank you for your help and recommendation!

 

[Duke Dive Medicine]

Never mind. Link is back up and I've got the number to call for an appt.

Thank you for your help and recommendation!

Weird. Sorry about the technical glitch, glad you got an appointment!

Best regards,
DDM