Cardiac ultrasound for everyone considering diving?

[freewillie]

most physicians in the medical community (myself included) are unaware of the 'official' recommendations for medical clearance when it comes to scuba diving. the DAN site refers multiple medical conditions but gives very few specifics on what is requried for screening purposes. it is up to the individual doctor then to determine what is appropriate or not.

In regards to ASD in particular, it is second most common congenital heart defect in adults. Generally, the patients present with symptoms shortness of breath, poor exercise tolerance, irregular heart beats, and congestive heart failure. Most patient present before the age of 40, although some adults may not present until age of 60.

IMO if an otherwise healthy adult with good exercise capacity on history (how much exercise/activity can you do) does not need a screening cardiac stress test or echocardiogram. If you have a history of hypertension, then as long as it is controlled with medications you would be okay. If you have a prior history of heart disease (history of heart attack, cardiac bypass surgery or angioplasty), then you need a formal cardiac stress test before you can dive. For patients with asthma, it is a relative contraindication and depends on the severity. If you are over 50 I would recommend at least a chest x ray and an EKG.

I would also be interested if any other MD's and their opinions on what is appropriate for medical clearance for scuba.

 

[TSandM]

Your physician is, I think, actually referring to PFO, or patent foramen ovale. I guess you could call it a form of atrial septal defect, although the two terms are usually used in reference to different things. PFOs are quite common, as you learned . . . and there is some suggestion that they may be associated with certain cases of Type II DCS. But since 25% of the population has one, and 25% of divers do not get DCS, there are clearly a great many people out there diving with PFOs without problems. Routine screening for PFO is not recommended by anyone I know, even for technical divers.

And if one truly wants to screen for a PFO, a simple echocardiogram is not sufficient. You need either a transesophageal echo with bubble contrast, or a transcranial Doppler. So even if your doctor is worried about ruling out a PFO before approving someone for diving (something for which there is really no good basis) he is recommending the wrong test.

 

[farsidefan1]

I will start out with full disclosure. I had a ASD corrected after an unprovoked DCS hit in Coz. Prior to that my normal dive schedule was 4-5 dives per day on dive vacations. I had about 150 dives prior to the hit with no problems. On the trip with the hit I took a very long walk in the August heat and was probably dehydrated. The PFO test is a bit of a pain and I see no need for it unless you have some other indications of a problem. I suspect thousands of divers with ASDs and PFO's dive regularly with no problem as I did. Find another doctor.

 

[knowone]

I used to do my own, and watch my heart beating with one eye and the tv
with the other but that became boring after a while so I tried the cat same
thing so I invited some people I knew over, and some pregnant people but
then I moved and took it to the tip. Had I known, I could have mailed it to
Connecticut

 

[Kenny13]

My son had open heart surgery slightly over 2 years ago to repair an aortic stenosis. This past July, his cardiologist signed off on his medical release form so he could take his OW class without even doing an examination. Granted, he sees his cardiologist annually and had an ultrasound 6 months prior, but there was no hesitation when it came to signing off on his release.

 

[drbill]

I had the option of having a cardiac ultrasound at our annual health fair for $50. Unfortunately by the time I got to the booth, their appointments were all booked. I did get 7 other ultrasound examinations plus a test of my arterial circulation in my extremities for a total of $45. If you have health fairs in your area, check to see if this test is available there... or by a RT ticket to Catalina (off Lost Angeles), have the test done and spend some time diving the kelp forests of Casino Point just below the Casino building where the health fair occurs every April!). You'll get a lot more for your money that way!

Hmmm... just read what Lynne posted. Maybe you should just come for the diving!

 

[lulubelle]

I had the option of having a cardiac ultrasound at our annual health fair for $50. Unfortunately by the time I got to the booth, their appointments were all booked. I did get 7 other ultrasound examinations plus a test of my arterial circulation in my extremities for a total of $45. If you have health fairs in your area, check to see if this test is available there... or by a RT ticket to Catalina (off Lost Angeles), have the test done and spend some time diving the kelp forests of Casino Point just below the Casino building where the health fair occurs every April!). You'll get a lot more for your money that way!

Hmmm... just read what Lynne posted. Maybe you should just come for the diving!

Bill, you can't really see what needs to be seen with a simple echo. Unless you have a big PFO. You have to do a bubble test, color test, something to look at flow between the chambers. Doesn't sound like the OP has any history that would warrant this expensive test.

Kind of freaky to watch the bubbles shooting into my heart.