Palpitations and diving?

[PaScubaGirl70]

Hi,
I have my 1st ocean dive coming up the first week of Dec. in the Riviera Maya. I am very excited!! The past several months, I have had several episodes of palpitations. The doctors have me wearing a 30 day event monitor. It is showing tachycardia at times. Also, I am hyperthyroid. I tend to have more anxiety than normal. I could tell it affected my last dive this summer. I was able to control it, but it is a little unnerving. The doctors in my area are not knowledgable about diving and the conditions I have. Can anyone please advise me whether I should be diving on this trip or not. I really want to -- but safety first.
Please help!
Thanks,
PaScubaGirl70

 

[Wildcard]

I think you answered your own question, safety first. Call DAN and get a referal for a dive doc and talk to them. Good luck.

 

[60feet]

... The doctors in my area are not knowledgable about diving and the conditions I have.

My brother is an internist MD, my doctor is a Stanford graduate, and I have over a dozen friends who are doctors... none of them is knowledgeable on diving medicine or dive-related potential injuries, as these represent a very specialized medical field. Suggest you send a PM to Dr. Deco and Doc Vikingo for information. They have been very helpful to me personally. You'd be in good hands. Good luck.

 

[pescador775]

Let me guess, PAgirl, you have had dizzyness or faintness to go with the rest? It probably would be unwise to drive a car or operate certain types of machinery, much less dive, until the problem is controlled. After that happens, it would be time to revisit the dive issue. It used to be that only the very fit were capable of passing a Scuba course. That alone tended to weed out the marginal. Nowadays, if one is walking and talking the various agencies and DAN would probably give the go-ahead with certain disclaimers. This is seen frequently in their literature. That is not the way to approach this. You can't dive with "palpitations" or especially tachycardia, period.

 

[TSandM]

I rarely agree with Pescador, but in this case, I do.

If you are hyperthyroid AND having tachycardia, you need to get your endocrine problem under control before you go underwater. A tachydysrhythmia brought on by the adrenaline and excitement of your first dive could literally be lethal.

I would suggest a period of several months free of tachycardia before going underwater, although a DAN physician may be more liberal (I don't know).

Diving is fun, and I'm totally addicted to doing it, but some things just don't make sense, and knowing you have significant potential for an incapacitating event to occur underwater seems to me to be loading the odds against you to an unacceptable amount.

 

[Dr. Doug Ebersole]

I'm sorry but, as a cardiologist, can I interject here? "Palpitations" are an extremely common complaint and the differential diagnosis of the problem ranges from the innocent normal sinus rhythm, through benign atrial rhythms, to very serious ventricular rhythm abnormalities. The first step is a monitor (as you are doing) in hopes of identifying what rhythm is associated with your symptoms. Obviously, if you are hyperthyroid that needs to be corrected. Often, an echocardiogram is also ordered to rule out structural heart disease which could predispose you to certain rhythm abnormalities.

If your symptoms are related to dangerous ventricular arrhythmias (very unlikely in an otherwise healthy individual without known heart disease -- but possible), you should not dive as they can cause sudden death. Additionally, they could cause syncope (loss of consciousness) which could be "annoying" on land but fatal underwater.

Atrial arrhythmias are annoying but not fatal. However, your response to them underwater if you were to panic could put you in a life-threatening situation.
The usual first step in treating premature atrial contractions (skipped beats) or certain regular fast rhythms (SVT) is avoidance of know stimulants (caffeine, alcohol, tobacco, etc). Medicines can be used in selective cases and the usual drugs used (beta blockers, calcium channel blockers, digoxin) can all be used safely while diving. Depending on what rhythm problem you have, how it needs to be treated, and how you respond to that treatment you may or may not be able to dive. However, the vast majority of divers with "palpitations" can dive. Just get it evaluated before diving. I tell all my patients "you pay me to worry, that's my job".

For the lurking lawyers, the above is my personal opinion and you should seek out a knowledgeable diving medicine physician to discuss your individual case ......... Blah, Blah, Blah.......

In case your physician is interested, additional information is available in the textbook Diving Medicine by Alfred Bove, MD.

If I can be of any further assistance, PM me.

Doug

 

[Cacia]

I was tempted to add that I had this problem for awhile and an ablation for my AVNRT completely cured the problem.

I almost did not do it because it was so frightening as a concept, but it has eliminated the pathway.

YAY! for technology!!!