Deep dive tachycardia, or panic?

[Madhiker_99]

During a deep dive to 127’ with air, I had a tachycardia event out of the blue. As I hit this depth, I felt a sudden onset of strong narcosis which I was prepared for. I immediately began a slow controlled ascent, and as I did, the narcosis became more pronounced. I then felt extreme racing heart which lead to fear of heart attack, so I carefully continued controlled ascent. My heart continued to race until I hit about 80’. The event caused me to greatly increase air consumption, but no other effects at the surface, and after a 90 minute interval, I completed a secend dive to 78’ with Nitrox, and no I’ll effects.

Thoughts on this as a physical event or mental/anxiey?

Im a 58 year old male in great shape with regular dives to 100’+ and regular exercise outside of diving.

I have 150 dives with no prior dive related anxiety

I don’t smoke, and had 2 beers 14 hours prior.

I may have been slightly dehydrated, but not overly.

3 cups of coffee pre-dive

I didn’t sleep great the night prior. Maybe 5 solid hours. I drank a cup of Valerian tea to help me sleep.

I have HBP and high cholesterol, both well controlled w/ meds. (BP 110/68)

Thanks for your thoughts!

 

[rsingler]

Sudden tachycardia "out of the blue" suggests a sudden onset SVT, perhaps precipitated by your caffeine + subclinical nitrogen effects + slight dehydration. That is a possibility, depending upon which blood pressure medications you are taking. Less likely if your medications include a beta blocker. More likely if, as your username suggests, you are a mad hiker with a rather low baseline heat rate, and your SVT was an escape rhythm perhaps after your pulse slowed a bit further, for any of a number of reasons.
But all this is just a hypothetical WAG.

 

[scubadada]

I think it far more likely that you had a panic related tachycardia than an episode of supraventricular tachycardia. If this happens again, you may want to obtain consultation.

 

[sprockjohnson]

I have had the same type of "racing hearbeat" at about the 130' depth several times. Not sure what it is but similar profile as yourself in regards to dehydration, coffee, Valerian tea, previous nights alcohol consumption, and BP medications (Valsartan and Amlodapine in my case). It seems to happen at that exact depth, vanishes as I ascend to the 90-100' mark, and does not repeat again if I descend again a bit later.

 

[Duke Dive Medicine]

During a deep dive to 127’ with air, I had a tachycardia event out of the blue. As I hit this depth, I felt a sudden onset of strong narcosis which I was prepared for. I immediately began a slow controlled ascent, and as I did, the narcosis became more pronounced. I then felt extreme racing heart which lead to fear of heart attack, so I carefully continued controlled ascent. My heart continued to race until I hit about 80’. The event caused me to greatly increase air consumption, but no other effects at the surface, and after a 90 minute interval, I completed a secend dive to 78’ with Nitrox, and no I’ll effects.

Thoughts on this as a physical event or mental/anxiey?

Im a 58 year old male in great shape with regular dives to 100’+ and regular exercise outside of diving.

I have 150 dives with no prior dive related anxiety

I don’t smoke, and had 2 beers 14 hours prior.

I may have been slightly dehydrated, but not overly.

3 cups of coffee pre-dive

I didn’t sleep great the night prior. Maybe 5 solid hours. I drank a cup of Valerian tea to help me sleep.

I have HBP and high cholesterol, both well controlled w/ meds. (BP 110/68)

Thanks for your thoughts!

Can you describe extreme tachycardia a little more? Just going by what you've written, it's possible that the nitrogen narcosis induced anxiety which in turn produced tachycardia. Also, immersion changes the distribution of blood flow such that there's a relatively large volume of blood in the torso, which influences the amount of blood that returns to the heart. This could have made the tachycardia feel more pronounced.
Has this ever happened to you before under any other circumstances?

Best regards,
DDM

 

[Madhiker_99]

Can you describe extreme tachycardia a little more? Just going by what you've written, it's possible that the nitrogen narcosis induced anxiety which in turn produced tachycardia. Also, immersion changes the distribution of blood flow such that there's a relatively large volume of blood in the torso, which influences the amount of blood that returns to the heart. This could have made the tachycardia feel more pronounced.
Has this ever happened to you before under any other circumstances?

Best regards,
DDM

Thanks for the reply. I’ve had tachycardia from too much alcohol. Reviewed by my cardiologist which included echocardiogram that found no damage. Recommendation was - stop drinking too much! Easy fix.

Heart was racing very fast during dive episode. I estimate 150 bpm, which caused fear of heart attack, likely further aggravating the panic.

Thinking the narcosis, plus restricted blood flow from pressure, caffeine, etc are likely culprits. All things for me up consider next time. Along with other responses to this thread.

Best!

 

[jadairiii]

During a deep dive to 127’ with air, ....I felt a sudden onset of strong narcosis .... as I did, the narcosis became more pronounced. I then felt extreme racing heart which lead to fear of heart attack....

You got whacked on air, as you started your ascent, my guess is, you started to pump the legs just a bit, more C02, which just exasperates the narcosis, that is why as you ascended you felt more whacked, which then lead to the "flight or fight" reaction. Heart rate increases and so does breathing rate.

This is your wake up call, time for a Trimix course. Run a scenario, you or your buddy had a failure or emergency when you hit 127'.......that day does not end well. I have been flamed on here before, but any dive below 90' becomes a "technical" dive and the rules change.

 

[FishWatcher747]

The challenge for you is to "capture" one of your episodes of tachycardia on a heart monitor. The reason this is critical is right now you don't know what rhythm you are in during these episodes. Might be a fast normal rhythm from anxiety. Maybe not. If it is a fast normal rhythm no big deal, go about your business. If it is an abnormal rhythm it is likely to become more frequent and long lasting in the future. Having a fast rhythm for a few seconds or a few minutes might not get your attention. How about a few hours or a few days?

Capturing it is unlikely to be practical while diving. While not diving though there are urgent cares and ERs and Dr. offices you might capture it. If it were me I would get a home monitor to try to capture it.

Edit: When I say home monitor I am not talking about a home monitor to measure your pulse I am saying get a home EKG monitor like this, $79

KardiaMobile EKG l Wireless EKG

Hold your heart in your hands: Kardia captures a medical-grade EKG in 30 seconds anywhere, anytime. Captures Heart Rate, Rhythm & Symptoms for Early Detection of AFib | For Smartphones & Tablets | FDA Cleared.

www.concordhealthsupply.com

 

[FishWatcher747]

You got whacked on air, as you started your ascent, my guess is, you started to pump the legs just a bit, more C02, which just exasperates the narcosis, that is why as you ascended you felt more whacked, which then lead to the "flight or fight" reaction. Heart rate increases and so does breathing rate.

This is your wake up call, time for a Trimix course. Run a scenario, you or your buddy had a failure or emergency when you hit 127'.......that day does not end well. I have been flamed on here before, but any dive below 90' becomes a "technical" dive and the rules change.

When he got tachycardia while drinking alcohol was he "whacked on air"?

 

[grantctobin]

When he got tachycardia while drinking alcohol was he "whacked on air"?

I’d wager he was breathing air…

At least until the medics masked him