• HOME
• COURSES
• DIVING
• DIVE SITES
• EQUIPMENT
• INJURIES
• LESSONS
• SEA LIFE

Home › Scuba Diving Directory › Injuries in Scuba › Heart Attack

Scuba Diving with Heart Conditions

There are several cardiovascular issues that affect diver safety, and a diver's ability to carry out moderate exercise underwater, especially when breathing with scuba gear.

These guidelines highlight the risk factors associated with scuba diving and coronary artery disease (CAD), and the long term implications of diving after a heart attack.

Can You Scuba Dive with a Heart Condition?

Besides pre existing heart conditions, the common predisposing factors for divers to have a scuba diving heart attack, include:

• Being male, over fifty, a smoker, and eating a high fat diet
• Diabetes mellitus (DM)
• Heart overexertion symptoms (e.g. swimming against strong currents)
• Hypertension (high blood pressure)
• Obesity
• Using certain types of drugs or medications before the dive

Pro Tip: According to the current medical guidelines, the risk of having a heart attack while scuba diving may also increase for divers with a family history of coronary heart disease (CHD).

What is Coronary Artery Disease (CAD)?

Also known as atherosclerosis, it is an excessive build up of a sticky substance, called 'plaque', on the inside of the artery walls.

The common term "hardening of the arteries" describes the deposition of the waxy, fat-like substance in the blood, called cholesterol. As a result, the walls of the arteries get thicker and restrict normal blood flow.

In case you were wondering:

In general, adult women who produce estrogen have a lower risk of developing heart problems. Even so, coronary artery disease is the leading cause of death in many countries, including the United States.

Scuba Diving with Heart Problems

Some medical conditions can stop you from scuba diving altogether. Plus, symptomatic coronary artery disease is an outright contraindication to safe diving and you should not go diving if you have it.

Why?

Strenuous exercise increases the need for oxygen, especially myocardial tissue of the heart. Furthermore, hypoxia (insufficient oxygen) can cause:

• Arrhythmia (abnormal heart rhythms)
• Myocardial infarction (heart attack)

As a consequence of that, chest pain after scuba diving is one of the classic symptoms of coronary artery disease (CAD).

Yet, some divers and snorkelers have no symptoms at all until they experience a heart attack - sometimes during the actual dive or while swimming at the surface. So in that respect, scuba diving can cause a heart attack - or at least be a contributing factor!

But wait - there's more:

It's also true to say that cardiovascular disease is a significant cause of scuba diving deaths every year. The best way to avoid becoming a statistic is to get regular checkups and medical evaluation, such as physical stress tests at a hospital.

According to the American College of Cardiology, scuba diving may be safe for some heart patients. But, any diver with coronary disease should have good left ventricular function and adequate aerobic capacity as a proviso.

They also advise scuba divers with heart problems to choose calm diving destinations with warm water, and avoid cold water environments and dive sites with strong currents.

DAN Advice: In certain circumstances, such as when prescribed medications and medical procedures (e.g. cardiac pacemaker implant) prove successful, individuals may be able to make a full return to scuba diving after approval from their physician.

Scuba Diving after a Heart Attack

If you're wondering whether you can scuba dive after heart attack or after heart surgery, the answer relates to the heightened risk factors that using scuba equipment underwater poses, such as:

• Being immersion in cold water (e.g. ice diving)
• Breathing hyperbaric gases at elevated pressures
• Performing strenuous exercise
• Stress (and the potential for panic)
• Gas bubbles circulating in the blood (especially post dive)

Moreover, as we get older, the capacity for the heart to support an elevated blood output decreases, even more so after suffering heart failure (MI).

What is Myocardial Infarction (MI)?

Myocardial infarction is the medical term used to describe heart attacks. Simply put, interrupted (or absent) blood flow and oxygen can cause damage to the cells of the heart muscle.

Blocked arteries reduce, or stop, the normal blood circulation to the heart tissue. In turn, this deprives the cells of essential oxygen, resulting in some damage (a scar). In fact, this can occur without any obvious heart attack signs and symptoms for the individual.

In general, this kind of coronary thrombosis can lead to an irregular heart or a cessation of beating altogether, also known as sudden cardiac arrest (SCA).

Heart Attack Signs and Symptoms

Among the most common symptoms of heart attack is central chest pain that radiates to the upper arms and even into the jaw area. But, other manifestations can include:

• Pallor (unhealthy pale appearance often with excessive sweating).
• Indigestion (sometimes with nausea).
• Dyspnea (shortness of breath), dizziness, and anxiety.
• Heart irregularities often with palpitations.
• Cyanosis (blueness around the lips and nail beds).
• Mydriasis (fixed, dilated pupils).
• Unconsciousness (no breathing and pulse).

Heart Attack Implications for Divers

Sadly, the scuba diving fatality rate includes around 30% of deaths caused by cardiovascular events while actually in the water, submerged or at the surface.

Cardiac failure also causes around 21% of snorkeling deaths and inhalation of water (drowning) accounts for 67% of all cases.

Here's the thing:

A medical practitioner will make the decision about returning to scuba diving after a heart attack - along with any specific restrictions. Hence, they may approve participation if the diver meets the necessary fitness requirements and is in general good health for scuba.

Nevertheless, there is no absolute guarantee that any diver will not experience a cardiovascular event while scuba diving.

As a consequence of that, it is not the responsibility of resort operators to decide who can - and who cannot - dive if cardiovascular disease is an issue.

Pro Tip: According to current guidelines set out by the Divers Alert Network (DAN), the right to deny service gives dive professionals the authority to decline acceptance of any diver who compromises safety for staff, the business, other divers - or themselves!

Heart Attack First Aid Treatment (conscious diver)

• Provide oxygen if available and trained to do so (preferably by a constant flow delivery system).
• An injured diver who is short of breath may prefer to be sitting upright.
• Call for immediate medical assistance and monitor the patient's consciousness, open airway, breathing, and circulation (pulse).

Heart Attack Emergency Treatment (unconscious diver)

STOP: Assess and observe the scene

THINK: Consider your safety and form an action plan

ACT: Check for patient responsiveness

ALERT EMS

• Begin cardiopulmonary resuscitation (CPR) by providing thirty (30) chest compressions, then open the airway, and give two (2) normal breaths.
• If you suspect the person has drowned, begin CPR with the two rescue breaths before administering the chest compressions.
• Compress an adult chest to a depth of at least five (5) centimetres (2 inches) and give compressions at a rate of at least one hundred (100) per minute - push hard and push fast!
• To minimise interruptions in chest compressions, if there is more than one rescuer present, and you have access to an automated external defibrillator, continue CPR while the AED is switched on and the pads are being placed on the patient.
• According to the American Heart Association (AHA), there is reduced emphasis on barrier use when providing CPR, although still recommended. But, treatment should not be delayed if barriers are not immediately available.
• If the patient begins breathing, manage serious bleeding wounds, follow the basic steps for managing shock symptoms, and protect the patient from the environment (sun, rain) and against excessive movement (e.g. spinal injury).

DAN Advice: After addressing all cardiovascular issues, a diver who can exercise to a minimum of 7 km/h on a treadmill may be able to go scuba diving after a heart attack.

Divers also enjoyed reading about...