Diving Heart Attacks

[rstofer]

Once again, the solution is obvious: if you are over 40, don't dive! In fact, we could save over 80% of diving fatalities by just prohibiting diving for those over 40.

One of the better things about KNOWING you have coronary artery disease (CAD) is that the meds (such as Atenolol) prevent the heart from accelerating and you get angina at the slightest overexertion. So, you slow down. Take a break... Float on your back. After all, that's the greatest feature of a BP/W!

My cardiologist just said "Hm..." when I mentioned scuba diving. No comittment one way of the other. But my GP had no problem with it. After all, it's not his CAD. Actually, he said he would be happy to sign off on those training waivers that most LDSs require. Maybe the HMO realizes that I have reached a point where I could cost them more than I pay and this is one solution to the aging problem.

It's probably just best to do what you want to do. Make your own decisions and live/die by the results. Don't overthink the problem. It's worked out ok so far!

Richard

 

[TSandM]

It is important to differentiate being fit from being without arterial disease; the two are related but not at all synonymous.

When I was a surgical resident, we had a plastic surgeon in the department who had a horrible family history for early heart disease. This guy ate a Pritikin diet, didn't carry an ounce of fat on his body, and ran compulsively. He dropped dead of an MI at age 38.

It is an unfortunate fact that the initial presenting symptom of heart disease is cardiac arrest in a large number of cases. It is felt that small plaques, which are not big enough to impede blood flow under normal circumstances, acutely rupture and occlude the vessel. Such plaques are not diagnosed by stress test, and sometime even on angiography, they are not felt to be big enough to require stenting.

I am not aware of anything that suggests that pressure, per se, has an effect on the coronaries. Oxygen, however, is a vasoconstrictor (albeit weak) so elevated ppO2s may have some effect.

 

[W8less]

Comming from an endurance sport background I've always wondered just what kinda workout is a dive. For the past 2 years I have been diving with a heart rate monitor and recording the data. What I have found from this unofficial research after a couple hundred dives is this.

First some qualifiers, Cold water, heavy gear varying currents and workload (hauling back dead scooters etc.). My average heart rate during those dives is approximately 60 to 70% of redline/max which falls into the BASIC aerobic category. Not much different than taking the dogs for a brisk walk or the stat bike with little resistance.

What surprised me was the fact that the greatest spike in heart rate comes from suiting up and getting in the water. Boat or walk in shore dive didn't matter.

Diving is exercise. It is much better than veggin on the couch but the real question to ask is should I go diving to get exercise or should I exercise to go diving? It is always the X factor, the unexpected that happens frequently enough underwater, that should determine your level of physical training and subsequent fitness. Ultimately the decision to be prepared is a personal one.

I agree with previous threads that genetics play an important role that exercise can't wish away. I also agree that diving presents a special condition, where underwater help is not as readily available and the consequences greater. Given those two facts it seems to me that an exercise commitment would expose those irregularities in an arena where help is more readily available

 

[captain]

What surprised me was the fact that the greatest spike in heart rate comes from suiting up and getting in the water. Boat or walk in shore dive didn't matter.

Doesn't surprise me at all, that is usually the hardest part of the dive especially if it involves donning a wet or dry suit. I usually relax for a minute or two after entry and let my heart rate and breathing return to normal.

 

[friscuba]

If you want an activity with a high rate of heart attacks.... take a cruise.

When I first got over here I worked in a shop downtown and rented some snorkel gear to a gal and a couple of guys that were involved with a cruise ship activities staff. They went down to the local snorkel beach and were back about 4 hours later, I asked them how it was, they said kind of depressing... they spent some of the time doing CPR on a guy who had a heart attack snorkeling with his kids.... said they're used to it, apparently it's reasonably common for people who are rarely active go on the cruise ships and party and eat themselves to death. This was a New Zealand to the US trip with Hawaii being a stopping point and they said the morgue was already full, they'd be using the meat locker the rest of the trip. I hadn't thought about death being not all that uncommon in the cruise industry, it's mostly about the audience that participates.

Point being, scuba's pretty much the same... lots of people involved with it aren't that active in their daily lives, and they're throwing themselves into a foreign environment and exerting themselves, heart attacks are going to happen on occasion. It doesn't necessarily make it more inherently dangerous than other sports or activities, it's probably more attractive to the out of shape crowd than activities that might be looked at as being more physically rigorous.

 

[Nemrod]

I have been reading numerous dive magazines and seeing that one of the main causes of SCUBA related deaths are due to Heart Attacks. Is there another reason for this other than the person being out of shape, or already at risk?? Does anything related to the physics of Scuba diving, i.e. the mix of air, the depth, the pressures etc., have anything to do with the heart attacks or is it just that the physical activity causes them on unsuspecting peoples, so these same victims could have just as easily went jogging for the first time in 10 years and had a heart attack too??

Long ago a scuba class I was involved in instructing, it was a huge class like they used to be with 30 plus students. I fortunately was with group number 2 on the second dive out. The boat went out with group number 1 and one of the gents passed away with a heart problem. My friend also an, well, never mind that, did his best to get him back to the boat and they did perform rescue breathing. It was a horrible thing and as I was barely 20 at the time I did not understand what I know now, middle age couch potatoes, stress, a heavy wet suit, breathing through a reg, a bit of panic and it is as if there is a tripping point.

That day was a change for me, I no longer, well, that was it.

It is very difficult to provide treatment in the ocean, on a boat and have good outcomes. You getting older people out there, like me, get in shape, don't push yourself, if you feel pushed and stressed then back off and let your buddy know you are not comfortable. That uncomfortable feeling is a warning.

N