HOCM question

[judson60318]

I have recently been diagnosed with possible Hypertrophic Obstructive Cardiomyopathy. I have had a stress test which was negative, however it did reveal LVH and a pressure gradient of 60 mmHg in the left ventricle. I am currently seeing a cardiologist in Atlanta who has put me on diving restriction until I have a cardiac MRI. I realize that having HOCM puts me at risk for going into a ventricular arrhythmia. I have 30 dives logged with no problems. I also feel that the cardiologist is putting me on diving restriction because he is unsure of the effects that diving may have on my heart. Any thoughts on continuing to dive or any suggestions to cardiologist that have a better understanding of diving?
Thanks,
Judson

 

[cutlass]

I'm not a cardio but 60mm sounds odd in two contexts: If it's the peak left ventricular (LV) pressure, it's low by about half. If it's the gradient between the LV and aorta, it's quite higher than normal; meaning that the full pump pressure is not being felt at the aorta, something usually seen with a heart valve problem.

I think it would be wise to wait and have your condition evaluated. Given the dynamic environment involved, scuba diving is considered to be a high-activity sport. IIRC, the currently recommended MET* level of cardiac fitness is a very high 13. I don't recall there being conclusive connections made between HOCM/HCM, exercise level, and serious cardiac events (especially, sudden cardiac death). But there seems to be enough anecdotal evidence so that there's a fair consensus that those with HOCM/HCM should avoid high-intensity exercise**.

*Metabolic equivalent, task. It's an index calculated from measurements taken during a treadmill test following what's called the "Bruce protocol".

**Apparently, the feeling is that the additional heart muscle mass is more than can be serviced by the coronary vessels during/after peak exercise.