myocardiopathy/ arrythmia

[docrich]

I want some comments on this. Presently on toprol xl for combination of hypertension and irregular heartbeat. Under excellent control, before toprol xl would get syncope after 1-2 hrs heavy exercise but only after resting awhile, never while exercising.. Cardiologist says heart actually is smoother under exercise than while at rest. Can bike strenuosly for 2 hrs. Best heartrate now is 120. Cardiologist is not familiar with diving and said I might be ok to dive, found a dive doc and he felt that as long as no deep dives or dives in strong current I would be ok. From my research I have lingering doubts. Any experts out there or similar situations?

 

[Saturation]

I want some comments on this. Presently on toprol xl for combination of hypertension and irregular heartbeat. Under excellent control, before toprol xl would get syncope after 1-2 hrs heavy exercise but only after resting awhile, never while exercising.. Cardiologist says heart actually is smoother under exercise than while at rest. Can bike strenuosly for 2 hrs. Best heartrate now is 120. Cardiologist is not familiar with diving and said I might be ok to dive, found a dive doc and he felt that as long as no deep dives or dives in strong current I would be ok. From my research I have lingering doubts. Any experts out there or similar situations?

If one is fit on the surface and does little exertion at depth, the chances of health problems in-water are minimal. There is little known about most medications at depth.

A patient must perform an exercise or equivalent stress test with MIBI or thallium imaging without problems to a METS of 13, or to maximum predicted heart rate. An ejection fraction should be > 50%. Self attestation of exercise capacity is helpful, but quantification is needed.

A holter monitor should show no arrhythmias that could potentially be life threatening, preferrably including exercise.

Identifying the type of cardiomyopathy helps predict its future behavior.

Periodic re-testing with stress + holter are helpful among those in sports to insure the exercise it itself doesn't accelerate problems. For example, sarcoid, amyloid and arrhythmogenic right ventricular cardiomyopathies are less predictable as the diver ages, even if initial results are acceptable say today.

Ischemic, dilated and hypertensive cardiomyopathies deteriorate more predictably or remain healthy if improvements are made to their primary condition [angina and hypertension] and if patients perform the above tests well, so repeated testing may not be necessary.

When to retest is unclear, but I would consider it if any dives are planned to areas with limited medical facilities.

Dive conservatively and in optimal conditions [>80F water, vis >= max depth, ~ 0 current] to reduce mental and physical stress. Currents may not be an issue if one only drifts whereas in shore diving with surf, fighting surf cannot be avoided. Avoid feeling chilled or heavy swimming to minimize a risk for immersion pulmonary edema.

 

[docrich]

If one is fit on the surface and does little exertion at depth, the chances of health problems in-water are minimal. There is little known about most medications at depth.

A patient must perform an exercise or equivalent stress test with MIBI or thallium imaging without problems to a METS of 13, or to maximum predicted heart rate. An ejection fraction should be > 50%. Self attestation of exercise capacity is helpful, but quantification is needed.

A holter monitor should show no arrhythmias that could potentially be life threatening, preferrably including exercise.

Identifying the type of cardiomyopathy helps predict its future behavior.

Periodic re-testing with stress + holter are helpful among those in sports to insure the exercise it itself doesn't accelerate problems. For example, sarcoid, amyloid and arrhythmogenic right ventricular cardiomyopathies are less predictable as the diver ages, even if initial results are acceptable say today.

Ischemic, dilated and hypertensive cardiomyopathies deteriorate more predictably or remain healthy if improvements are made to their primary condition [angina and hypertension] and if patients perform the above tests well, so repeated testing may not be necessary.

When to retest is unclear, but I would consider it if any dives are planned to areas with limited medical facilities.

Dive conservatively and in optimal conditions [>80F water, vis >= max depth, ~ 0 current] to reduce mental and physical stress. Currents may not be an issue if one only drifts whereas in shore diving with surf, fighting surf cannot be avoided. Avoid feeling chilled or heavy swimming to minimize a risk for immersion pulmonary edema.

Thanks for the info, I have had the thallium test and stress tests, though I don;t know the actual #'s but I'm going to call the cardiologist and find out. He said he is totally unfamiliar with diving.