Safe Diving w/Aneurysm?

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Diver4242

Registered
Messages
32
Reaction score
5
Location
Nazareth, PA
# of dives
200 - 499
I've had an aortic aneurysm for a few years (that I know of) plus some nodules, etc. The aneurysm has grown from 4.1cm in 2019, 4.3 in Oct 2020, and last week I had a CT that shows it at 4.8cm. The report is below. Is it safe for me to dive? I'm also a Divemaster and work in a rental shop so I lug tanks, weights, run the gift shop, air fills, etc. I messaged Dr. Ebersole on his page, couldn't see how to tag him here.

There is an ascending thoracic aneurysm measuring 4.8 x 4.8 cm in the axial projection at the pulmonary window. Continue surveillance of the aneurysmal dilatation on a yearly basis. There are bilateral lung nodularities, largest one measuring 6.8 mm at the right upper lobe and at the left apex measuring 7 x 6.7 mm. As per Fleischner criteria a follow-up CT scan is recommended in 3 months. Linear changes at the right upper lobe might represent apical scaring. Total DLP: 286 mGy/cm. CTDI volume 7 mGy.
 
Hi @Diver4242

Monitoring and treatment of a thoracic aortic aneurysm is not specifically a diving problem. The decisions are based on the size and rate of growth of the aneurysm. Have you been advised by your cardiologist, cardiothoracic surgeon?

@Dr. Doug Ebersole

Thank you for your fast reply, Dr. Ebersole. I haven't been advised yet, I just saw the cardiologist last last week at the VA medical center. I'm sure she'll be in touch this week. But I'm concerned she may not be familiar with diving and just tell me not to dive anymore?
 
Thank you for your fast reply, Dr. Ebersole. I haven't been advised yet, I just saw the cardiologist last last week at the VA medical center. I'm sure she'll be in touch this week. But I'm concerned she may not be familiar with diving and just tell me not to dive anymore?
Reply was not from Dr Ebersole, I simply tagged him on my brief reply
 
I've had an aortic aneurysm for a few years (that I know of) plus some nodules, etc. The aneurysm has grown from 4.1cm in 2019, 4.4 in Oct 2020, and last week I had a CT that shows it at 4.8cm. The report is below. Is it safe for me to dive? I'm also a Divemaster and work in a rental shop so I lug tanks, weights, run the gift shop, air fills, etc. I messaged Dr. Ebersole on his page, couldn't see how to tag him here.

There is an ascending thoracic aneurysm measuring 4.8 x 4.8 cm in the axial projection at the pulmonary window. Continue surveillance of the aneurysmal dilatation on a yearly basis. There are bilateral lung nodularities, largest one measuring 6.8 mm at the right upper lobe and at the left apex measuring 7 x 6.7 mm. As per Fleischner criteria a follow-up CT scan is recommended in 3 months. Linear changes at the right upper lobe might represent apical scaring. Total DLP: 286 mGy/cm. CTDI volume 7 mGy.

Hi @Diver4242 ,

"Some nodules, etc." needs more explanation. Nodules from what? How many are there? Where are they located? What do you mean by "etc."? In general, lung nodules could lead to air trapping in the lungs, so you'll need someone to interpret the CT scan and tell you whether you're at risk for this or not, but depending on what's going on with you, there could be other medical contraindications to diving.

Re your aneurism, this is a question to be answered in person by your cardiologist and a physician experienced in examining divers. UPenn Hyperbaric Group in Philadelphia is probably the closest to you for the latter. I'm linking an old thread below with some information on aortic aneurism; @Dr. Doug Ebersole may have something to add aside from what he wrote in this thread.

Bicuspid Valve and Aortic Root Dilation

Best regards,
DDM
 
Below is more info from the CT scan last week, regarding the nodules. I know the lung scarring was from some exposures during my military service (late 70's), and likely from working in a cement plant in the early 80's, before masks were worn. I never smoked.

The heart is normal in size. There is no pericardial
effusion. Great vessels appear grossly unremarkable. There is an
ascending thoracic aortic aneurysm measuring 4.8 x 4.8 cm in the
axial projection at the pulmonary window and 4.6 cm in the
sagittal projection. On image #21 series 3 at the left upper lobe
there is a somewhat spiculated nodularity measuring 7 x 6.7 mm.
On image #78 series 3 at the peripheral left lower lobe there is
a cluster of micronodules largest one measuring 3 mm. At the
right upper lobe there are some linear changes which might
represent apical scaring. Associated with this linear changes
however there are several lung nodules: On image #24 series 3
measuring 6.8 mm, on image #27 measuring 4.5 mm, on image #29
measuring 3.8 mm. On image #33 at the right upper lobe there is a
juxtapleural nodularity measuring 3.7 mm, on image #40 at the
left upper lobe there is a 2.7 mm nodule, on image #41 there is a
triangular-shaped left upper lobe nodularity measuring 5.4 x 5.9
mm, on image #46 at the right upper lobe measuring 3.7 mm, on
image #58 at the right lower lobe measuring 3.1 mm, on image #58
at the left lower lobe measuring 6.3 mm (linear nodule). There
are no hilar or mediastinal masses or clinically significant
adenopathy based on size. Calcified subcarinal peritracheal, and
prevascular space lymph nodes noted secondary to granulomatous
disease. Bilateral subcentimeter and borderline size axillary
adenopathy noted. No infiltrates or effusions are seen. Airways
and esophagus are patent. Thyroid gland appear unremarkable.
There are minimal degenerative changes of the spine.

There is a right upper pole renal cyst.
 
Below is more info from the CT scan last week, regarding the nodules. I know the lung scarring was from some exposures during my military service (late 70's), and likely from working in a cement plant in the early 80's, before masks were worn. I never smoked.

The heart is normal in size. There is no pericardial
effusion. Great vessels appear grossly unremarkable. There is an
ascending thoracic aortic aneurysm measuring 4.8 x 4.8 cm in the
axial projection at the pulmonary window and 4.6 cm in the
sagittal projection. On image #21 series 3 at the left upper lobe
there is a somewhat spiculated nodularity measuring 7 x 6.7 mm.
On image #78 series 3 at the peripheral left lower lobe there is
a cluster of micronodules largest one measuring 3 mm. At the
right upper lobe there are some linear changes which might
represent apical scaring. Associated with this linear changes
however there are several lung nodules: On image #24 series 3
measuring 6.8 mm, on image #27 measuring 4.5 mm, on image #29
measuring 3.8 mm. On image #33 at the right upper lobe there is a
juxtapleural nodularity measuring 3.7 mm, on image #40 at the
left upper lobe there is a 2.7 mm nodule, on image #41 there is a
triangular-shaped left upper lobe nodularity measuring 5.4 x 5.9
mm, on image #46 at the right upper lobe measuring 3.7 mm, on
image #58 at the right lower lobe measuring 3.1 mm, on image #58
at the left lower lobe measuring 6.3 mm (linear nodule). There
are no hilar or mediastinal masses or clinically significant
adenopathy based on size. Calcified subcarinal peritracheal, and
prevascular space lymph nodes noted secondary to granulomatous
disease. Bilateral subcentimeter and borderline size axillary
adenopathy noted. No infiltrates or effusions are seen. Airways
and esophagus are patent. Thyroid gland appear unremarkable.
There are minimal degenerative changes of the spine.

There is a right upper pole renal cyst.

Thanks for the details. The text "airways are patent" is reassuring but I'd want more details on whether any of the nodules could be impinging on alveolar ducts and potentially lead to air trapping. Again recommend seeing the folks at UPenn Hyperbarics for medical clearance to dive. Are they going to biopsy any of these?

Best regards,
DDM
 
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