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
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2020
January
February
Group Fitness at the PoolHow to Rescue a Distressed diver at the SurfaceHow to manage Near-DrowningNo Sit-ups no problem How to manage MalariaHow to manage Oxygen Deficiency (Hypoxia)What to do when confronted by a sharkHow to manage Scombroid PoisoningHow to perform a Deep Diver RescueHow to perform One-rescuer CPRHow to perform a Neurological Assessment
March
DAN’s Quick Guide to Properly Disinfecting Dive GearCOVID-19 : Prevention Recommendations for our Diving CommunityGermophobia? - Just give it a reasonable thoughtScuba Equipment care – Rinsing and cleaning diving equipmentCOVID-19 and DAN MembershipFurther limitations imposed on travels and considerations on diving activitiesDAN Membership COVID-19 FAQsLancet COVID-19 South African Testing SitesCOVID-19 No Panic Help GuideGetting Decompression Sickness while FreedivingDown in the DumpsCardiovascular Disease and DivingDelayed Off-GassingDiving after Dental surgeryDiving with Multiple MedicationsPygmy Seahorses: Life AquaticAfrica DustCOVID-19 Myth BustersScuba Units Are Not Suitable Substitutes for VentilatorsDisinfection of Scuba Equipment and COVID-19Physioball Stability Exercises
April
COVID-19 AdvisoryScuba Equipment Care - Drying & Storing Your GearTransporting Diving Lights & BatteriesHow to Pivot Your Message During a CrisisTourism Relief FundCOVID-19 Business Support ReviewDiving After COVID-19: What We Know TodayEUBS-ECHM Position Statement on Diving ActivitiesPart 2: COVID-19 Business Support ReviewPress Release
May
Diving in the Era of COVID-19Dive Operations and COVID-19: Prepping for ReturnCOVID-19 & Diving Activities: 10 Safety RecommendationsCOVID-19: Surface Survival TimesThe Philippines at its FinestThe Logistics of ExplorationThe Art of the Underwater SelfieShooter: Douglas SeifertFAQs Answered: Disinfecting Scuba EquipmentStock your First-Aid KitResearch and OutreachCovid-19 ResearchOut of the BlueEffects of Aspirin on DivingThe New Pointy end of DivingDiving and Hepatitis CCaissons, Compressed-Air work and Deep TunnellingPreparing to Dive in the New NormalNew Health Declaration Form Sample Addressing C-19 IssuesDiving After COVID 19: What Divers Need to Know
June
Travel Smarter: PRE-TRIP VACCINATIONSAttention-Deficit/Hyperactivity Disorder and DivingCOVID-19: Updated First Aid Training Recommendations From DANDiving with a Purpose in National Marine SanctuariesStay Positive Through the PandemicFor the Dive Operator: How to Protect Your Staff & ClientsStudying Deep reefs and Deep diversAsking the Right QuestionsLung squeeze under cold diving conditions
July
Dive DeprivationVolunteer Fish Surveys: Engage DiversDAN Member Profile: Mehgan Heaney-GrierTravel Smarter: Don’t Cancel, Reschedule InsteadDive Boat Fire SafetyRay of HopePartner ExercisesDiving at AltitudeAluminium ExposureHip FracturesAcoustic NeuromaGuidelines for Lifelong Medical Fitness to DiveNew Dive Medical Forms
August
Women in Diving: Lauren Arthur, Conservationist & Natural History Story TellerWomen in Diving: Dr Sara Andreotti White Shark ResearcherTiming ExerciseWomen in Diving: The Salty Wanderer, Charlie WarlandWomen in Diving: Beth Neale, Aqua soul of freedivingWomen in Diving: Diving and spearfishing Diva, Jean HattinghWomen in Diving: Zandile Ndhlovu, The Black Mermaid
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Freediving For ScienceStep Exercises with CardioFluorescence Imaging help Identify Coral BleachingChildren and DivingThe Watchman device and divingScuba Diving and Factor V Leiden gene mutationNitrogen Narcosis at shallow depthsOil and Particulates: Safe levels in Breathing Air at depthDive Principles for Coping with COVID-19The Importance of a Predive Safety CheckTalya Davidoff: the 'Plattelandse Meisie' Freediver
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2018
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May
When things go wrongEmergency Planning: Why Do We Need It?Breath-hold diving: Running on reserve -Part 5 Learning to RebreatheSweet Dreams: When Can I Resume Diving Post Anaesthesia?Investing in the future of reefsTo lie or not to lie?THE STORY OF A RASH AFTER A DIVEFirst Aid KitsTaravana: Fact or Falacy?
June
Oxygen Unit MaintenanceKnow Your Oxygen-Delivery Masks 1Know Your Oxygen-Delivery Masks 2Emergency Oxygen unitsInjuries due to exposure - HypothermiaInjuries due to exposure - Altitude sicknessInjuries due to Exposure - Dehydration and other concernsHow to plan for your dive tripThe Future of Dive MedicinePlastic is Killing our ocean
September
Return to DivingDiagnoses: Pulmonary blebSide effects of Rectogesic ointmentDiving with ChemotherapyReplacing dive computers and BCDsCustomize Your First-Aid KitPlan for medical emergenciesHow the dive Reflex protects the brain and heartDry suits and skin BendsAltitude sickness and DCSScuba Diving and Life Expectancy
2017
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Incident Insight: TriageA Field Guide to Minor MishapsSnorkels: Pros & ConsTime & RecoveryMedication & Drug UseDiving with CancerNitrox FAQCOPD FAQHyperbaric Chamber FAQJet Lag FAQHydration FAQAnticoagulant Medication FAQFluid in the Ear FAQEye Surgery FAQElderly Divers FAQNitrogen FAQHealth Concerns FAQMotion Sickness FAQMicronuclei FAQ
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Breath-Hold Diving & ScubaReturn to Diving After DCITiming Exercise & DivingHot Tubs After DivingSubcutaneous EmphysemaIn-Water RecompressionDiving at AltitudeFlying After DivingDiving After FlyingThe Risks of Diabetes & DivingFlu-like Symptoms Following a DiveHand & Foot EdemaFrontal HeadachesBladder DiscomfortLatex AllergiesRemember to BreatheProper Position for Emergency CareAches & PainsCell Phones While DrivingSurfers Ear Ear Ventilation TubesDealing with Ear ProblemsDiving with Existing Ear InjuriesPerforated Ear DrumENT SurgeryUnpluggedCochlear ImplantsPortuguese Man-of-WarJellyfish StingsLionfish, Scorpionfish & Stonefish EnvenomationsStingray Envenomation Coral Cuts, Scrapes and RashesSpeeding & Driving Behaviour
June
Newsflash! Low Pressure Hose DeteriorationItching & rash go away & come back!7 Things we did not know about the oceanMigraine HeadacheAttention Deficit Disorder Cerebral Vascular AccidentEpilepsyCerebral PalsyHistory of SeizuresMultiple Sclerosis Head TraumaBreast Cancer & Fitness to Dive IssuesLocal Allergic ReactionsSea LiceHow ocean pollution affects humans Dive Fatality & Lobster Mini-Season StatisticsPregnancy & DivingReturn to Diving After Giving BirthBreast Implants & DivingMenstruation During Diving ActivitiesOral Birth ControlBreast FeedingPremenstrual SyndromeOsteoporosisThe Aftermath of Diving IncidentsCompensation Legislation & the Recreational DiverNoise-Induced Hearing LossLegal MattersThe Nature of Liability & DivingDAN Legal NetworkWaivers, Children & Solo DivingHealthy, but overweight!Taking Medication while Scuba DivingGetting Fit for the Dive SeasonBone Considerations in Young DiversAsthma and Scuba DivingHepatitisDiving with HyperglycemiaShoulder PainDiving After Spinal Back Surgery
August
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2015
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