Diving with mitral regurgitation and a small PFO?
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Aussiefish
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Hello, this has suddenly become an interesting topic to me and I hope to get some feedback on a sililiar condition.
First some background, I'm a 59 year old male, non smoker, non drinker and reasonably fit. Gym 3 to 4 nights per week and swim 1k 4 times per week. For the last 10 years I've competed in 5+ open water swimming races each year ranging from 1k to1.5k's. I had slightly elevated blood pressure which is controlled by Telmisartan. Only been diving for 4yrs and logged 50ish dives, mostly in temperate (cold) waters in southern Australia. Prior to commencing diving I had a complete medical and also saw a cardiologist (non diving) who saw no issues with diving. My SPUMS Dr (who was also my regular doctor) and was aware of my medical history cleared me to dive.
Recently I decided to do my AOW certification so again went to my cardiologist (my wife likes to be reassured as I'm not getting any younger) who conducted another stress ECG and Echocardiogram.
My stress ECG was fine and my echocardiogram was similiar to my previous one:
'Trivial to mild mitral regurgitation and trivial aortic regurgitation with normal biventicular size and systolic function. Mild concentric LVH is noted. Left atrium is mildly enlarged'
This is unchanged since my first one 4 yrs ago and again he cleared me for diving.
Current issue, my regular Dr has moved on and I've been advised that the local SPUMS Dr probably won't pass anyone who doesn't have a clear Echocardiogram. I haven't been to him yet as it's quite expensive and I don't want to waste the money.
Hope to get some feedback from medically qualified people. What would you recommend?
A. Stop diving.
B. Continue diving without going for the advanced qualification.
C. Go for the advanced qualification.
D. Get another SPUMS medical and hope to pass.
Cheers
First some background, I'm a 59 year old male, non smoker, non drinker and reasonably fit. Gym 3 to 4 nights per week and swim 1k 4 times per week. For the last 10 years I've competed in 5+ open water swimming races each year ranging from 1k to1.5k's. I had slightly elevated blood pressure which is controlled by Telmisartan. Only been diving for 4yrs and logged 50ish dives, mostly in temperate (cold) waters in southern Australia. Prior to commencing diving I had a complete medical and also saw a cardiologist (non diving) who saw no issues with diving. My SPUMS Dr (who was also my regular doctor) and was aware of my medical history cleared me to dive.
Recently I decided to do my AOW certification so again went to my cardiologist (my wife likes to be reassured as I'm not getting any younger) who conducted another stress ECG and Echocardiogram.
My stress ECG was fine and my echocardiogram was similiar to my previous one:
'Trivial to mild mitral regurgitation and trivial aortic regurgitation with normal biventicular size and systolic function. Mild concentric LVH is noted. Left atrium is mildly enlarged'
This is unchanged since my first one 4 yrs ago and again he cleared me for diving.
Current issue, my regular Dr has moved on and I've been advised that the local SPUMS Dr probably won't pass anyone who doesn't have a clear Echocardiogram. I haven't been to him yet as it's quite expensive and I don't want to waste the money.
Hope to get some feedback from medically qualified people. What would you recommend?
A. Stop diving.
B. Continue diving without going for the advanced qualification.
C. Go for the advanced qualification.
D. Get another SPUMS medical and hope to pass.
Cheers
OK, so it has been a while since I've been here but I thought I would provide an update on this ancient thread as it may be of interest and links back to the history.
I stopped diving in 2013 after reaching 75 dives, principally as I was getting less confident about diving with the condition along with the usual excuse of a significantly increased workload in my day job. I was fine and dong many other things without problems until mid 2016. I then started to feel drained and nauseous after intense exercise but put it down to my work hours. By January 2017 I went grey and nearly passed out after walking up a moderate hill but still didn't quite twig what was happening..... Luckily I had my annual heart check a week later which confirmed a marked worsening of the valve regurgitation from mild / moderate to severe. After further tests (Angiogram, trans oesophageal echo) the recommendation was for repair or replacement surgery within a year rather than waiting. This was because long term and potentially irreversible ventricular enlargement was a risk. In the 9 months from diagnosis to surgery my condition became noticeably worse so in my mind I made the right choice.
In September 2017 I underwent openheart surgery for mitral valve repair which was a complete success (last checkup in May 2019, no leakage at all, ECG better than before the worsening apparently). As I wanted to return to diving I asked the surgeon to also close up the PFO which he wouldn't have bothered with otherwise. That is now also completely sealed (confirmed with agitated saline, trans thoracic echo). I was initially on beta blockers and aspirin but I've not been on any medication since June 2018.
I've been back at work since November 2017, full time since January 2018 and now feel pretty good. Since the operation I've been sailing and snorkelling in the Med and climbed 3 Munros (hills over 3000 ft in Scotland). Cardiologist has signed me off for diving on air to 30m and I hope to return to diving either this year or next year. I'm currently trying to gradually improve my general fitness and strength before attempting to wrestle dive gear in and out of quarries and on shore dives. Initially I intend to go back to basics with pool dives, theory refresh etc. and then see what happens....
I stopped diving in 2013 after reaching 75 dives, principally as I was getting less confident about diving with the condition along with the usual excuse of a significantly increased workload in my day job. I was fine and dong many other things without problems until mid 2016. I then started to feel drained and nauseous after intense exercise but put it down to my work hours. By January 2017 I went grey and nearly passed out after walking up a moderate hill but still didn't quite twig what was happening..... Luckily I had my annual heart check a week later which confirmed a marked worsening of the valve regurgitation from mild / moderate to severe. After further tests (Angiogram, trans oesophageal echo) the recommendation was for repair or replacement surgery within a year rather than waiting. This was because long term and potentially irreversible ventricular enlargement was a risk. In the 9 months from diagnosis to surgery my condition became noticeably worse so in my mind I made the right choice.
In September 2017 I underwent openheart surgery for mitral valve repair which was a complete success (last checkup in May 2019, no leakage at all, ECG better than before the worsening apparently). As I wanted to return to diving I asked the surgeon to also close up the PFO which he wouldn't have bothered with otherwise. That is now also completely sealed (confirmed with agitated saline, trans thoracic echo). I was initially on beta blockers and aspirin but I've not been on any medication since June 2018.
I've been back at work since November 2017, full time since January 2018 and now feel pretty good. Since the operation I've been sailing and snorkelling in the Med and climbed 3 Munros (hills over 3000 ft in Scotland). Cardiologist has signed me off for diving on air to 30m and I hope to return to diving either this year or next year. I'm currently trying to gradually improve my general fitness and strength before attempting to wrestle dive gear in and out of quarries and on shore dives. Initially I intend to go back to basics with pool dives, theory refresh etc. and then see what happens....
Wow! What wonderful awesome news. So very pleased for you.
And thank you so much for coming back and telling us about this. I look forward to reading more about your diving adventures in the near future.
And thank you so much for coming back and telling us about this. I look forward to reading more about your diving adventures in the near future.
That's great news, thank you for the follow-up!
Best regards,
DDM
Best regards,
DDM
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