Some people wish to return to diving after having a heart attack, or after procedures like cardiac stenting or angioplasty (otherwise known as heart bypass surgery, or revascularisation). These procedures may be done after a heart attack, or if you suffer from angina.
Other conditions include disturbances of heart rhythm (termed arrhythmias), and disease of the heart valves, which may be picked up as a heart murmur.
There is a chance you may be able to return to diving with some of these conditions, but you will always need further investigation and an annual dive medical. There are risks associated with a return to diving that can be managed but will never be reduced back to those of the general population.
Your diving may need to be restricted to certain depths, times, and to no decompression diving, and you may not be deemed fit to dive with novice divers.
The first step is to book a telephone consultation with one of our diving doctors, to discuss your medical history in more depth and advise on the next steps. Advice from a Cardiologist with a special interest in diving medicine may be required.
Broadly speaking, a heart attack means the heart has been damaged. To go diving again, we need to know that the heart will function well enough to withstand the stresses of diving (both anticipated and unanticipated) and not put you at risk of incapacity or death underwater.
You will need to have an echocardiogram and an exercise stress test (or similar) to test cardiac function and response to exercise. You may have already had these done but if not, you may have to have them done privately as it may not form part of your standard NHS care.
Your risk of having a further heart attack or stroke will also need to be carefully managed. Please see the relevant sections on high cholesterol, high blood pressure and obesity.
Revascularisation is used to widen coronary arteries that have become narrowed by coronary artery disease. This can be performed percutaneously (using a wire inserted either in your groin or wrist). Stents are used to hold the coronary arteries open, and can be fitted in an emergency in people who are having a heart attack or as a planned procedure in people that are having angina or chest pain. Open heart surgery can also be performed to graft blood vessels from elsewhere in the body onto the heart, to restore the blood supply – termed coronary artery bypass grafting (CABG).
Some people are able to go diving again after these procedures but each case has to be considered individually. Most people who have had cardiac stents have been put on antiplatelet drugs (medication to stop platelets clumping together causing blockages) and this needs to be carefully considered.
Heart rhythm disturbance
You may be able to dive after further investigation and a dive medical. This decision will depend on the nature and cause of the rhythm disturbance, whether you experience symptoms (such as shortness of breath, dizziness, chest pain or loss of consciousness), whether there is (or is potential for) any underlying structural damage to the heart, and whether you take any medications for your condition.
As with other forms of cardiac disease, you will need further investigations which may need to be arranged privately.
Heart valve disease
It is unlikely you will be fit to dive with significant heart valve disease, as the ability of the heart to function is often impaired. This will be detected on an echocardiogram.
Following heart valve replacement or repair, it may be possible to dive following a period of time and after specialist investigation and review. There are many theoretical risks associated with this, ranging from failure of the replacement valves to the medications that you may be taking.