Q4_Fall_2016_AlertDiver

FALL 2016

RESEARCH, EDUCATION & MEDICINE

FROM THE MEDICAL LINE

An important consideration relative to the device is the

pressure rating. These particular devices are often rated

only to an ambient pressure of 2 atmospheres absolute

(33 feet of seawater). Medtronic, one manufacturer, states

that exceeding this pressure could lead to degradation of

the system. Furthermore, exceeding the recommended

maximum pressure could lead to changes in the way

the device works or cause it to fail, which would require

surgical removal and reimplantation. People with

neurostimulators can determine the pressure rating of their

system by reviewing in the literature provided to them the

sections that address sports and other activities. They can

also get information by calling the toll-free number on the

device identification card and providing the serial number.

Another consideration that shouldn’t be overlooked

is the underlying reason for the device. That condition

must be evaluated with respect to any potential

problems with diving.

— Scott Smith, EMT-P

I am 48 years old and have moderate

hypertension. I was diagnosed with

pulmonary stenosis, which was surgically

corrected. The pulmonary valve, however, is

allowing some blood to leak, permitting backflow.

Is this a disqualifier for scuba diving? What

short-term and long-term risks are involved

in diving with this medical issue?

Whether or not a medical condition

disqualifies a person from diving depends

on several factors, including the severity

of disease and the presence of ass

ociate

d medical

conditions. The diver must undergo a thorough

evaluation by a doctor, and fitness to dive must be

considered on a case-by-case basis. The general

comments here are intended to provide background

on pulmonary valve insufficiency and some of the

associated cardiac issues that influence decisions

regarding fitness to dive.

Deoxygenated blood returning from the body

enters the heart before making its way to the lungs

for reoxygenation. Pulmonary valve insufficiency may

result in the backward flow of blood (regurgitation)

into the right ventricle of the heart. Minimal or

mild pulmonary insufficiency is common in many

people with otherwise healthy hearts and rarely

requires medical intervention.

Although mild pulmonary

insufficiency may not manifest

with symptoms, individuals with

a more severe condition may

experience fatigue, shortness

of breath (especially during

physical exertion), exercise

intolerance, fainting, palpitations

or chest pain. Backflow may

result from a number of medical

conditions, including congenital

malformation, pulmonary

hypertension and pulmonary

stenosis.

Pulmonary stenosis, a

narrowing between the right

ventricle and pulmonary artery,

results in an obstruction in the

flow of oxygen-poor blood from

the heart to the lungs. Even after

being corrected, pulmonary

insufficiency may still be present.

Whether or not regurgitation

disqualifies someone from

diving depends on the severity

of regurgitation, the existence of

underlying myocardial disease