vsd heart murmur and diving

[darkmoon3d]

I was born with vsd heart murmur (size of pin needle) and has never affected me entire life. Am 33 and have been diving since 98 with no trouble. 8 years ago I had a checkup on heart which shows the murmur has closed. My general doctor recommends not diving deeper than 50ft. Should I be overly concerned with depth in diving even though I no longer have vsd condition? Have looked up on scubaboard other divers cases of this but can't find what to do if condition no longer exists. Can understand doctor being a little too on safe side but is this really a problem?

 

[TSandM]

There are two issues here. One is the murmur, which is a sound -- murmurs can point to anatomic problems in the heart, or they can be completely benign, "physiologic" murmurs. The other is the hole in the ventricular septum, which is your "ventrical septal defect", or VSD. If an echocardiogram shows that this has closed, you have a heart like anyone else's, and you can dive just like anyone else would do. The only caveat is that echoes are not perfect, and there may still be a small hole with no blood flowing through it under resting conditions. It would probably be wise to avoid pushing NDLs, and to do stepped ascents designed to minimize bubble formation; you might also be a very good candidate to dive Nitrox for all your dives. But that's based on the false negative rate of echocardiography in evaluating VSDs, and I don't know what those numbers are. debersole, here on SB, might have better information for you.

 

[Duke Dive Medicine]

Darkmoon,

It sounds like you're saying that the origin of the murmur was the VSD itself... is that the case? Also, do you have any additional cardiac or other medical issues?

If the VSD was the source of the murmur, it has closed, AND you have no other cardiac or medical complications, I wouldn't see any reason to put a 50-foot restriction on your diving, especially in the absence of an accompanying bottom time restriction. That said, your GP examined you in person and may have a legitimate rationale. Did he/she explain his/her reasoning?

Simple VSD with no other complications is not necessarily a contraindication to diving. The pressure in the left ventricle is much higher than that in the right, which typically prevents right-to-left bubble shunting in the ventricles.

Best regards,
DDM

 

[TSandM]

Good point, DDM, and a good example of why I shouldn't post when I'm tired. Atrial septal defects would be more of a bubble risk than VSDs.

 

[Dr. Doug Ebersole]

I agree completely with TSandM and Duke Dive Medicine. It sounds like your ventricular septal defect has closed which is very common. And even if it has not but is very small it is extremely unlikely to cause any problems with diving. The pressure in the left ventricle is markedly higher than the right ventricle in this situation and should not reverse even with Valsalva, lifting heavy items, etc so there should not be the problem of right to left shunting that you would worry about with an ATRIAL septal defect