Aortic aneurysm....end of the dive?

[Rick1956]

Hi. I have been struggling lately with the decision lately of whether I should continue diving or call it day. I am 61 years old and had an ascending aortic aneurysm discovered 5 years ago during a CT scan for another issue. The specifics are “ the root measures 4.3 cm, the ascending aorta 4.2 cm, aortic arch 3.1 cm,proximal descending aorta 2.8 cm and distal descending thoracic aorta 2.6 cm. There is no evidence of subintimal dissection.” I have controlled BP and had a “normal range” stress test. METS were 13.5 . I have a CT annually and there has been no change in size over the last 5 years. I am otherwise healthy and active. I work in the construction industry and am aware of lifting constraints. I am an avid cyclist and typically ride 30-45 miles at 80-90% max HR. I have been diving all along but as i get older feel I might be pushing my luck. My cardiologist is not a diver and is currently researching the effects of diving with a TAA. I’ve read a lot of online information from many sources, some from well known medical institutions, that seem to contradict each other. I hate to think I may have to stop diving, but I also hate to think of not living. Any new information out there? Thanks.

 

[Altamira]

You might consider the possible downsides of posting such detailed personal medical information on an open internet forum. The information you posted would likely result in being denied a dive by most dive ops unless you had a letter from your cardiologist stating you are cleared for diving, and even with the letter, you still might be declined. If it was me, I would delete your post, and would be asking these questions directly to DAN, Duke Dive Medicine, and perhaps you can can find a cardiologist that is a diver, or find a Navy/ex-Navy dive medical officer to help you with your decision. Good luck.

 

[mbs]

Seriously? How exactly would a dive op tie mr rick1956 with the Rick who just walked into his shop?

 

[northernone]

I wouldn't know how to advice you. And from the sound of it, the jury is out in the medical field. Personally I'd hate to see you hang up your fins unless there is fairly conclusive reason to do so.

I hope someone more information can help.

Regards,
Cameron

 

[Altamira]

Seriously? How exactly would a dive op tie mr rick1956 with the Rick who just walked into his shop?

Seriously? Well, assuming the dive op frequents SB, I wonder how many certified divers named Rick, with 200-499 dives, who were born in 1956, and living in Cape Cod, MA? May be a lot, or not.

Regardless of the likelihood of a dive op getting this information, it seems unwise to put one's personal HIPPA protected information on an open website like SB, especially since he could get help by directly contacting medical professionals that might be able to give needed recommendations. My advice was meant only for his own protection and security of his medical information. It is hard enough to protect our personal information in today's leaky media systems without us giving it away.

 

[Duke Dive Medicine]

Rick,

Unfortunately this is difficult to study and each case is individual. There are a few general considerations though.

As I'm sure you're aware, elevated blood pressure increases the risk of dissection. Immersion can increase blood pressure, and immersed exercise can increase it further. However, exercising on land at the level that you do will also increase it. How the two compare in you would be tough to measure outside a specialized lab. The fact that your aneurysm has remained stable despite your strenuous exercise is reassuring; that may change as you age.

I'm sure you also know that the consequences of rupture are grave, and the further from help you are, the less your chances of survival would be in that situation. You can't live your life an arm's length from an operating room, but it might be a consideration if you're thinking about a live-aboard vacation in a remote area.

I'm not sure if Dr. Doug Ebersole (a tech-diving interventional cardiologist) is still active on SB; I can't seem to find him to tag him but I'll put @debersole in here in the hopes that he can chime in and provide more details for you.

Best regards,
DDM

 

[drbill]

I'm not sure if Dr. Doug Ebersole (a tech-diving interventional cardiologist) is still active on SB; I can't seem to find him to tag him but I'll put @debersole in here in the hopes that he can chime in and provide more details for you.

Best regards,
DDM

If you are on Facebook, I know Doug is there too as he is one of my friends on the site

 

[Duke Dive Medicine]

Thanks Bill, I sent him a FB message.

@Dr. Doug Ebersole is his new handle.

 

[Rick1956]

DDM and Dr. Bill, thank you for responding. I will continue to research this but in the mean time I’m sitting out (snorkeling) on my upcoming trip.

 

[Duke Dive Medicine]

DDM and Dr. Bill, thank you for responding. I will continue to research this but in the mean time I’m sitting out (snorkeling) on my upcoming trip.

Rick,

Again the risk is unknown in your case so take this for what it's worth, but the factors (immersion/immersed exercise) that could put you at additional risk while diving also apply to snorkeling. As I said, the fact that your aneurysm has remained stable with you exercising vigorously is reassuring so the risk is probably low, but it's something to keep in mind and ask your physician about before you go.

Best regards,
DDM