Cardiovascular Disease and Diving

Q: I had a stent placed earlier this year. My cardiologist is satisfied with the results and has cleared me to return to diving. The dive resort for my upcoming trip wants confirmation that the medications I’m taking are safe for diving. My doctor prescribed Brilinta (ticagrelor), Lasix (furosemide), Altace (ramipril), Zocor (simvastatin) and Toprol (metoprolol). I am 62 years old and have been diving for 34 years.
Unfortunately your question doesn’t have a one-size-fits-all answer. The most important thing to understand is that doctors do not evaluate medications for safety; they evaluate the diver. The question is not “Are my medications safe?” but rather “Am I safe to dive?” Although medications are an important consideration when determining your fitness to dive, it is often the underlying condition for which you take the medications that you and your doctor need to evaluate in detail. Medication side effects may be a concern for diving, but the underlying diagnosis should be the focus when deciding someone’s fitness to dive. Cardiovascular conditions need careful evaluation that may require input from both the cardiologist and dive medicine physician.
Compressed-gas diving introduces significant changes to the diver’s physiology that the body doesn’t experience with land-based sports. According to the 2018 edition of DAN’s Annual Diving Report, cardiac disease is the leading suspected cause of death for divers 50 years old and older while diving. A fitness decision for someone to return to regular exercise activities does not necessarily equate to whether someone is fit to dive.
The medications you listed are indicative of cardiovascular disease. While cardiovascular disease alone does not prevent you from diving, the extent of the disease may. Multiple medications may indicate multiple conditions that require control to minimize a heart attack or stroke. Any one medication is generally not an issue provided the condition is well-controlled, and your doctor needs to determine if diving would be a relatively safe activity for you. Your physician may want additional information such as exercise stress testing or even an echocardiogram to make that determination.
DAN is available to consult with doctors and discuss risk factors specific to diving so they can make an informed decision about your ability to dive safely. We want everyone to enjoy diving but not at the risk of a possible bad outcome from an otherwise preventable event.
— Lana P. Sorrell, MBA, DMT
Unfortunately your question doesn’t have a one-size-fits-all answer. The most important thing to understand is that doctors do not evaluate medications for safety; they evaluate the diver. The question is not “Are my medications safe?” but rather “Am I safe to dive?” Although medications are an important consideration when determining your fitness to dive, it is often the underlying condition for which you take the medications that you and your doctor need to evaluate in detail. Medication side effects may be a concern for diving, but the underlying diagnosis should be the focus when deciding someone’s fitness to dive. Cardiovascular conditions need careful evaluation that may require input from both the cardiologist and dive medicine physician.
Compressed-gas diving introduces significant changes to the diver’s physiology that the body doesn’t experience with land-based sports. According to the 2018 edition of DAN’s Annual Diving Report, cardiac disease is the leading suspected cause of death for divers 50 years old and older while diving. A fitness decision for someone to return to regular exercise activities does not necessarily equate to whether someone is fit to dive.
The medications you listed are indicative of cardiovascular disease. While cardiovascular disease alone does not prevent you from diving, the extent of the disease may. Multiple medications may indicate multiple conditions that require control to minimize a heart attack or stroke. Any one medication is generally not an issue provided the condition is well-controlled, and your doctor needs to determine if diving would be a relatively safe activity for you. Your physician may want additional information such as exercise stress testing or even an echocardiogram to make that determination.
DAN is available to consult with doctors and discuss risk factors specific to diving so they can make an informed decision about your ability to dive safely. We want everyone to enjoy diving but not at the risk of a possible bad outcome from an otherwise preventable event.
— Lana P. Sorrell, MBA, DMT
Posted in Alert Diver Spring Editions, Dive Safety Tips
Tagged with cardiovascular, Heart rates, Stay Fit, fitnes, Dive fitness, Stents
Tagged with cardiovascular, Heart rates, Stay Fit, fitnes, Dive fitness, Stents
Categories
2023
2022
January
February
UNCERTAINTY AFTER DIVING: Case Report and Recommendations #1.UNCERTAINTY AFTER DIVING: Case Report and Recommendations #2UNCERTAINTY AFTER DIVING: Case Report and Recommendations #3UNCERTAINTY AFTER DIVING: Case Report and Recommendations #4DIVERS LOSING ACCESS TO EMERGENCY CAREPreventing Breathing gas Contamination
March
When Should the Rescue Begin?Celebrating Young and Old in Turks and CaicosScuba Cylinder RundownChasing WeedsUnderwater Smartphone PhotographyAir and a SpareUnderwater Photographer: Fred BuyleBuilding Better BalanceLow-Visibility DivingMore Than a Sore ShoulderNot Only for DivingLaryngospasm and AnxietyPulmonary Hypertension and DivingTitan Meets TitanicPool Operation: Know Before you GoThe Argonaut Octopus and the jellyfishShort but Beautiful Lives
April
A Sense of PurposeMexico’s Sardine RunHigh-Pressure Hose injuriesA Hole in My HeartGoing UpConcussion and Return to DivingMarfan Syndrome Recommendations.South African Sardine Run by Walter BernardisSouth African Sardine Run By ProdiveSardine Run Port Elizabeth by ProDiveSardine Run Port St Johns by ProDiveScuba Diving In MauritiusScuba Diving in TanzaniaScuba Diving in the SeychellesScuba Diving in Nosy BeScuba Diving in MalawiScuba Diving in KenyaScuba Diving in South AfricaScuba Diving in Mozambique
May
June
July
Destination AntarticaUnconscious DiverA Little DetailDive Boat SafetyBlenny Watching 101Bonaire Inspires Hope for the Future of CoralThe Secret to Deep Freediving: Tips from 3 Female World Record HoldersEnsuring Safety in Freediving CompetitionsFour Tips For Staying Warm While Cold Water DivingAnd They Dived Happily Ever AfterFreediving Is About To Enter A New Era If Oxama Has Its SayGET BENT!The Joys and Challenges of the DeepUnderstanding The Secrets of Deep Freediving: Tips from Three National Record Holders
August
Pushing the Envelope: New Research into the Physiology of Deep Rebreather DivingFin Foot or DCS?Stop Smoking!Good AirEmergency Oxygen and Oxygen ToxicityFreedive with Psoriatic arthritisRebreather MythsShooter: David DoubiletDiving With My DadWhen History Seemingly Repeats Itself: DIADEMA SEA URCHIN LOSSPreserving History: Leslie LeaneyFreediving: Seeking and Finding Our Limits