Diving after a TIA

[divebomb]

Hey folks. As best as my physician can determine, I had a TIA on New Years Eve (2012/2013). I'm 57 yo, have high BP which is mostly under control, but was high at the time. It is down to a very nice level now.

I have read that diving with controlled high blood pressure is considered safe, diving after a TIA is absolutely not recommended.

I love diving so I don't want to give it up if I don't have to.

Here's my question....

Is diving after a TIA not recommended because of the chance that you could have another TIA underwater and possibly drown, or is it because the effects of pressure at depth could increase the chances of breaking off a clot and actually CAUSE a TIA?

If it's because of the former, maybe I'll take my chances. If it's the latter, I'm inclined to not push it.

Thanks,

Beck

 

[TSandM]

The answer isn't that simple.

Until the cause of the TIA is found and addressed, we don't precisely know the risk of recurrence or stroke. There are various methods of calculating that risk, based on the characteristics of the TIA and the underlying risk factors (HERE's an example). But what we do know is that certain causes of TIAs (ulcerated carotid plaque, or atrial fibrillation) are associated with much higher risk of stroke, and a stroke underwater would be a bad thing.

Is there anything about pressure changes that predisposes to stroke or recurrent TIA? I would be inclined to say no, as you are dealing with fluid-filled spaces which equalize pressure. But the adrenaline of diving, and the cold, can cause volume changes and blood pressure changes that CAN predispose to plaque rupture or arrhythmias.

If you have not already done so, you should undergo a thorough evaluation for the cause of the TIA, including carotid doppler, echocardiogram, and perhaps Holter monitoring if the circumstances warrant it. You might also undergo an examination for PFO, like a transcranial doppler. If the entire battery of tests fails to disclose a reason for the event, and your calculated stroke risk is low, then it's up to you to decide whether you want to continue to dive.

 

[divebomb]

The answer isn't that simple.

Until the cause of the TIA is found and addressed, we don't precisely know the risk of recurrence or stroke. There are various methods of calculating that risk, based on the characteristics of the TIA and the underlying risk factors (HERE's an example). But what we do know is that certain causes of TIAs (ulcerated carotid plaque, or atrial fibrillation) are associated with much higher risk of stroke, and a stroke underwater would be a bad thing.

Is there anything about pressure changes that predisposes to stroke or recurrent TIA? I would be inclined to say no, as you are dealing with fluid-filled spaces which equalize pressure. But the adrenaline of diving, and the cold, can cause volume changes and blood pressure changes that CAN predispose to plaque rupture or arrhythmias.

If you have not already done so, you should undergo a thorough evaluation for the cause of the TIA, including carotid doppler, echocardiogram, and perhaps Holter monitoring if the circumstances warrant it. You might also undergo an examination for PFO, like a transcranial doppler. If the entire battery of tests fails to disclose a reason for the event, and your calculated stroke risk is low, then it's up to you to decide whether you want to continue to dive.

As for tests, I had the carotid doppler, echocardiogram, stress test and a cat scan on my head. Everything came out good, so it seems like an anomaly. But something had to cause it. That's what bothers me - not knowing. I've got my yearly checkup next week so I'll ask about the PFO the Holter monitoring.

Thanks for the info.

Beck