Diving after Heart Attack

[mwm]

Hello Footslogger,

Glad to see you have such a positive attitude. That is a large factor in recovery.

I know another DM that has gone thru a very similar situation and is in the process of returning to diving. He is a little further down the road than yourself.

Contact him at:
1-888-476-5347
sales@scubamarketusa.com

Ask for Bobski. I am sure the two of you can compare notes.

 

[JCR]

I had an echo stress test this morning -- made it to 15+ METS and indications are that things are fine. I talk to the cardiologist next week and put the DAN form in front of him and then plan a trip to Cozumel or the Bay Islands.

JCR:

Assuming you have normal heart muscle function and good exercise tolerance -- on or off your meds -- you should be able to safely resume diving.

Doug

 

[susan johnson]

What is the DAN form? i have my stress test on monday and if all goes well i hope my dr will release me to start diving again. Is there some sort of form i should have him sign off on? thanks

 

[Footslogger]

Well, I started this thread so I thought it was only fitting that I post an update. My heart attack was in March 2008, as some of you might remember. It was complicated by a 4 hour ambulance ride to the hospital. I have significant left ventricular muscle wall damage and a pretty low ejection fraction. Since then I have developed some pulmonary hypertension.

It's been a long road back but about 2 weeks ago I had an echocardiogram and follow-up appointment with my cardiologist. He see's no reason why I can't do some SCUBA but has recommended that I limit my depths ...which seems like a reasonable compromise to me.

My wife and I are reviewing itineraries right now and might set something up for this winter. Even if I only get in this ONE last trip it will be worth it. The heart attack has been devastating for me, being the healthy person I always was. But I know there are a lot of folks out there with much more serious conditions to deal with.

'Slogger (Mark J)

 

[RBURN]

Sorry to hear about your MI....but you are here, and that's always a good thing!
I too had an MI, exactly one month after graduating from teacher's college and the start of a second career. In my case I had a 90% blockage of the circumflex artery, resulting in the placement of a stent...that was July '04. I am just getting back to diving, I was away from it for about 10 yrs. My first dive was this past Christmas in Cozumel. Prior to leaving, I had a follow-up stress test and a visit to my doctor...stress test yielded positive results and got the go ahead from my doctor (shallow dives...30-35 ft. should be OK) Everything went great, a little sinus problem getting down due to existing head cold, but OK. I am now taking a refesher for my Divemaster cert as I was certified prior to 1982 and am considered a non-affiliate divemaster. I am considering becoming an instructor, the previous MI will undoubtedly become an issue. Your story hits very close to home...I was extremely lucky to be given a second chance, minutes away from not being here. I have been teaching for five years...a profession I should have considered years ago, and now getting back to a sport I had a great passion for in the past.
All the best...

 

[Dr. Doug Ebersole]

Footslogger:

It's good to hear that you are doing okay. As a cardiologist and technical diving instructor, while limiting your depths is reasonable that is not really the main issue in diving after a heart attack. The main issue is the potential workloads involved. It is recommended that patients after a heart attack be able to exercise to 13 mets (about 12 minutes on a standard treadmill) before returning to diving and that they have normal heart muscle function (left ventricular ejection fraction above 50%). Additionally, they should have no evidence of a limitation to blood flow to their heart on stress testing.

The reason for these recommendations is that even the warmest, calmest, shallow Carribbean dive can turn into a lot of work if the seas pick up, currents develop, the diver surfaces a long way from the boat and has to make a long surface swim, or if he or she has to assist a buddy in trouble. All of these things are unpredictable and put both the diver and their buddy in jeopardy.

Another issue is the risk of dangerous heart rhythms with loss of consciousness after a heart attack. These are most often associated with weakened heart muscles or ischemia (limited blood flow to the heart). While a loss of consciousness topside can be dangerous and life-threatening, loss of consciousness under water is usually fatal.

It is not my intent to scare you or tell you not to dive. I just think you should understand the risks you are taking. Also, does your cardiologist know anything about diving? Most do not.

Life is all about weighing the risks and benefits of activities. If you and your (informed) cardiologist feel the risk of diving to you is low and your enjoyment from it is high, then if you and your buddy are willing to accept the risks, I would say return to diving.

Just my 2 cents.

Doug

 

[Footslogger]

Thanks for that Doug. I have to admit that I am being very cautious about my return to diving. I am somewhat atypical in that my left ventricular EF is lower than 50% and yet I am very functional. My own cardiologist admits that I am somewhat of an enigma. My exercise tolerance is actually quite good. I regularly maintain 3.5 - 4 mph at 5% incline on the treadmill for 20 minutes at least 3 days a week without pain, dysrythmia or shortness of breath. That being said, I hear you about the occasional unexpected need to deal with currents or long swims. All I can say is that I probably wouldn't jump in the ocean unless it was like a swimming pool. Even before the heart attack I had backed way off in terms of my diving style. I am pretty much a SCUBA slug right now ...and drop down directly below the boat, take some pictures and then get back onboard. Not the most exciting diving by most people's standards but at least I am getting in the water and using my u/w photo gear.

Always appreciate your feedback. Please keep it coming.

All the best ...

Mark J

 

[JCR]

Hello,

Glad to hear that you are considering back into diving at whatever physical level works for you. After my recent stress test I was encouraged, but by doc also suggested limiting my diving to warm water to contain the risks. Returning to diving has been a motivating factor for increasing my strength and overall cardio conditioning -- maybe I just needed a focus to step up my activity.

I am acutely aware that my dive partner -- in my case my wife -- may need my assistance and I need to have the physical conditioning to deal with that. I am sure there are other circumstances where you can return to diving and have the safety margin you need for yourself and your partner.

Keep up the recovery and good to hear you are making progress.

JR

 

[Footslogger]

For those of you who have had a heart attack and returned to diving ...what type of clearance letter/documentation did you obtain from your Cardiologist ?

Thanks in advance for any and all feedback.

'Slogger (Mark J)

 

[Dr. Doug Ebersole]

Mark:

It would be very uncommon to actually require a "clearance letter/documentation" from your Cardiologist to return to diving per se as it would be very rare that any dive operation would ask for one before allowing you on their boat. Returning to diving is more of a risk/benefit analysis made between you and your buddy to dive again. That being said, it would be a good idea to have a copy of the office note from your cardiologist where you discussed your return to diving just for documentation. It will be required if you decide to take any advanced training in the future as soon as you mention your prior heart attack on the medical form.

Doug