History of blood clots a contraindication for diving?

[pnw_diver]

First of all, I want to say that I'm going to get a referral to a physician knowledgeable in dive medicine before I resume diving. Right now, I'm looking for comments both from the medical community and from divers who have had a similar condition.

This was not in any way dive-related, I haven't dived in nearly 8 months.

This was a scary week for me. On Tuesday, I suffered a pulmonary embolism (PE) as a result of a deep-vein thrombosis (DVT) in my leg. I was discharged from the hospital this afternoon (Saturday). The current theory is that the DVT was a result of very long hours of desk work, though they are looking at genetic / inherited factors. The test results for that are not back yet. As a preventative measure, a IVC (inferior vena cava) filter was installed.

I have been told that I will fully recover from the PE and DVT. I don't have any intention of resuming diving until I have a medical opinion from a qualified physician.

Has anyone here had this medical problem and resumed diving?

Also, while I'm not looking for a personal medical opinion, I would like to understand what the medical consensus of diving with a history of PE / DVT is, so I'd like to hear comments from medical professionals as well.

 

[Duke Dive Medicine]

pnw,
Without any amplifying information on your medical history or the etiology of the clot, this is difficulty to answer. In general, one of the biggest concerns is whether you're on an anticoagulant. We typically advise people on anticoagulant therapy (e.g. warfarin/coumadin) to avoid diving due to the increased risk of uncontrolled bleeding from an injury, fall, etc.
Best regards,
DDM

 

[DandyDon]

I had a DVT once several years ago, but no complications.

 

[TSandM]

The long term implications of pulmonary embolus relate to the size and location of the clot. Small numbers of relatively peripheral emboli will generally resolve pretty well with time. Large, central emboli can result in some degree of pulmonary hypertension. This is usually worst in the acute setting, and improves with time. One of the determinants of future diving will be your exercise tolerance.

I am surprised they put in an IVC filter after a first event. Did they tell you if they intend to remove it later?

It usually takes some time to get a patient stabilized on the correct dose of Coumadin, which is a finicky medication to manage. Once the dose is stabilized and your INR is in the therapeutic range, it is really somewhat up to you about what you do. You are obviously at higher risk for bleeding after injury -- this is not so much an issue with peripheral wounds, but is a big one with head injury, which is obviously a consideration when diving off of boats.

I'm glad this got diagnosed and that you are doing well. PE is a terribly dangerous problem to have, and can be very difficult to diagnose, especially in an otherwise healthy person with none of the usual risk factors. Kudos to your docs!