Cardiac Discussion split from Diver missing from Vandenberg Wreck in Key West

[Nick_Radov]

Clean bill does not equal that all your arteries and veins are plaque=free - nobody can check that unless we invent nanobots circulating in our systems and taking pictures. I think people misinterpret what does a health check up mean.

A coronary CT scan including calcium score will do that for arteries. Veins are less of a concern.

The Heart Test You May Need—but Likely Haven’t Heard of

Meet the coronary calcium scan, an accurate test that can help determine your future risk of heart attack or cardiovascular disease.

www.hopkinsmedicine.org

This is a fairly complex and expensive test so it isn't typically done for routine screening, but patients with risk factors should discuss it with their doctor.

 

[Nick_Radov]

Nothing to do with getting lost in the wreck, he had a heart attack on rebreather during training.

A prolonged hypoxic event on a rebreather can also cause tissue damage that looks similar to a heart attack in an autopsy. I'm not saying that's what happened in the case you mentioned, but it can happen. Coroners who aren't familiar with dive medicine occasionally make mistakes.

 

[Wookie]

A prolonged hypoxic event on a rebreather can also cause tissue damage that looks similar to a heart attack in an autopsy. I'm not saying that's what happened in the case you mentioned, but it can happen. Coroners who aren't familiar with dive medicine occasionally make mistakes.

He had a heart attack the night before diving. I am not a doc, so I wouldn't know how to describe it except his skin was grey, he was sweating profusely and standing under the vent duct on a moderately cool day, for Key West anyway.

We asked him repeatedly if he was OK, he claimed he was just anticipating his rebreather dives ahead.

His instructor allowed him to make the dive. He went unresponsive on the deck of the Vandy at 95 feet, and as he was being brought to the surface, the lights went out at about 25 feet or so. I had divers on deco and was unable to effect a rescue with the big boat, and went after him in the dinghy. It is extremely difficult to get a #350 man into a dinghy when a #130 woman is driving and both other divers are now bent.

It was not a great day.

 

[Jake 10]

He had a heart attack the night before diving. I am not a doc, so I wouldn't know how to describe it except his skin was grey, he was sweating profusely and standing under the vent duct on a moderately cool day, for Key West anyway.

We asked him repeatedly if he was OK, he claimed he was just anticipating his rebreather dives ahead.

His instructor allowed him to make the dive. He went unresponsive on the deck of the Vandy at 95 feet, and as he was being brought to the surface, the lights went out at about 25 feet or so. I had divers on deco and was unable to effect a rescue with the big boat, and went after him in the dinghy. It is extremely difficult to get a #350 man into a dinghy when a #130 woman is driving and both other divers are now bent.

It was not a great day.

sorry to hear

 

[Jim Lapenta]

The diver I had experience with was 54 yrs old. Ran a farm as well as working for NIOSH. Full workup in May including ekg, eeg, treadmill stress test. Because of a family history of heart issues. He had none to that point. Took a strenuous rescue diver class in June. No issues. Deep diver class in August. Two weeks before class put up 300 bales of hay in his barn loft.
3 dives to 100 ft over 2 days with no issues. 4th dive going fine. On the ascent was ok at 50 ft stop for one minute to check buoyancy. At 40ft signals something wrong with a thumbs up. Responsive but in obvious pain to surface. Rolls over, spits out reg, says I can't breathe and goes unconscious.
Something broke loose and blocked the left ascending aorta. Aka a widow maker.
I see his face every time I get near water.

 

[The Chairman]

I am well into my 50s and would not be immune to a cardiac event.

I just had a cath done due to a slight heart murmur. No stents were put in and in fact, no problems were found at all. The doc told me I had the heart of a 30 year old and I quipped that I wasn't giving it back. I raced canoes back in HS, and that has had a huge benefit for my heart all these years later. Just because I'm 66 years old doesn't mean I'm a heartbeat away from cacking off.

 

[TravelGas]

Target Heart Rate by Age

Age	Moderate Intensity Target HR Zone 64% - 76%	Vigorous Intensity Target HR Zone 77% - 93%	Average Maximum Heart Rate
20 years	128-152 beats per minute (bpm)	154-186 bpm	200 bpm
25 years	125-148 bpm	150-181 bpm	195 bpm
30 years	122-144 bpm	146-177 bpm	190 bpm
35 years	118-141 bpm	142-172 bpm	185 bpm
40 years	115-137 bpm	139-167 bpm	180 bpm
45 years	112-133 bpm	135-163 bpm	175 bpm
50 years	109-129 bpm	131-158 bpm	170 bpm
55 years	106-125 bpm	127-153 bpm	165 bpm
60 years	102-122 bpm	123-149 bpm	160 bpm
65 years	99-118 bpm	119-144 bpm	155 bpm
70 years	96-114 bpm	116-140 bpm	150 bpm
75 years	93-110 bpm	112-135 bpm	145 bpm

As you can see from the chart, the heart does deteriorate with age. Cholesterol and plaque also build up from the age of 19 on, from the reading I have done. I don't see any 30 year olds getting a Cath done, but of course common in older people. I hope you are healthy and have a long diving career.

 

[Johnoly]

As you can see from the chart,

Just to make this relative under water...........
.

 

[Nick_Radov]

Target Heart Rate by Age

Age	Moderate Intensity Target HR Zone 64% - 76%	Vigorous Intensity Target HR Zone 77% - 93%	Average Maximum Heart Rate
20 years	128-152 beats per minute (bpm)	154-186 bpm	200 bpm
25 years	125-148 bpm	150-181 bpm	195 bpm
30 years	122-144 bpm	146-177 bpm	190 bpm
35 years	118-141 bpm	142-172 bpm	185 bpm
40 years	115-137 bpm	139-167 bpm	180 bpm
45 years	112-133 bpm	135-163 bpm	175 bpm
50 years	109-129 bpm	131-158 bpm	170 bpm
55 years	106-125 bpm	127-153 bpm	165 bpm
60 years	102-122 bpm	123-149 bpm	160 bpm
65 years	99-118 bpm	119-144 bpm	155 bpm
70 years	96-114 bpm	116-140 bpm	150 bpm
75 years	93-110 bpm	112-135 bpm	145 bpm

As you can see from the chart, the heart does deteriorate with age. Cholesterol and plaque also build up from the age of 19 on, from the reading I have done. I don't see any 30 year olds getting a Cath done, but of course common in older people. I hope you are healthy and have a long diving career.

Those charts are basically garbage and not to be relied upon for anything more than estimating an initial starting point for certain types of heart rate zone based endurance training. Maximum heart rate or gradual changes thereof doesn't tell us anything useful about fitness to dive or risk of a major adverse cardiac event. My actual measured heart rate in a 10/10 race effort is way higher than the chart would indicate (and I am not an elite athlete).

For fitness to dive we should look at actual cardiovascular system output as measured on something like a VO2 Max test, or a time trial to swim or run a certain distance. Probably also need some kind of strength test such as a farmer's walk.

For risk of heart attack and other major adverse cardiovascular events we should look at family history, presence of certain conditions (arrhythmia etc.), as well as certain screening tests such as apoB level and coronary artery calcium (CAC) score. Of course, there will always be some unfortunate outliers who experience a heart attack despite theoretically being at low risk.

 

[rongoodman]

I’m 76 and max out a little above 170. These numbers are just silly.