freediving with a heart problem

[peterk]

Hi,
I couldn't find a dive medicine forum ,
so here goes:

I am a singlehanded sailor.
In Nov 1997 I had an attack while alone at sea
(Western Carribbean)
Made it to Panama.

After an EKG
a cardiologist there called what I'd had
a pre-infarction
Nov 98 I had a heart catheter done.
Coronary arteries are okay,
diagnosis: Angina Pectoris
I am 62
I'm taking 10mg Nifedipine Retard
plus
1/4 Aspirin/day

Sept '99 in the warm water
of the Northern Galapagos
after easy-going training and
meditation I free-dove to 18 meters(60 feet)
to free my anchor stuck in lava.
No problem and afterwards I felt
like a million.
I did carry my nitro-spray
in one of these beach-money-tubes around my neck...

Any similar cases out there?
Medical opinions?

THANKS!

...peter, www.juprowa.com/kittel

 

[Erik]

I think this is one for Frank Pernett...if he doesn't see it, Ill let him know.
Cheers,
Erik Y.

 

[fpernett]

Serious question

Thanks Erik for let me Know

Hi Peter, your question is quite difficult to answer.
Probably what you had in 97 was an unstable angina.
The normal catheterism doesn't rule out coronary disease, because you can have compromise of small vessels that can't be seen with that test, that's why your cardiologist prescribe you nitro.
The freediving has special features that are dangerous for you:

1. Hypoxia : Despite the first 30 secs. of a freediving immersion are hyperoxic, the main part of it is hypoxic. You know what hypoxia make to your hear muscle
2. Mammalian Diving Reflex : The diving reflex consist of bradycardia (low heart rate) and vasoconstriction (narrowing of blood vessels), but besides this, the humans suffer transiet hypertension (high blood pressure), the last feature is specially harmful for you, because it increase the heart work and in this way the oxygen consumption, that is already low
3. Exercise: Unless you practice only static apnea, freediving involves a work load, and mainly under hypoxia
4. Blood-Shift: This phenomenom occurs with deep dives. It's caracterized by a shift of the blood flow from abdomen and extremities toward the chest, increasing the work load of the heart. Nobody can tell you the precise depth where this occurs
5. Acidosis: This means a low pH in your blood. After a freedive immersion you have acidosis (by CO2 retention and Lactic Acid Production), of course, it depends on the time and exercise of the inmersion. The acidosis lowers the threshold for cardiac arrythmias
   [/list=1]
   
   On the other hand, after 5 years you are asymptomatic. And I wonder if you really have a cardiac problem. I told you that a normal heart cathetherism doesn't rule out coronary disease, but after all this time without symptoms and making some exercise, I have to question if the diagnosis was right.
   I recommend you to take a cardiac stress test and to see a cardiologist to confirm the diagnosis and your current health status.
   But you have to remember that freediving is different from a cardiac stress test, and you will have to discuss it with your cardiologist.
   I'm a Freediver, and I don't imagine if someone prohibit me to do it.
   It's very hard to give you an "electronic" advice.
   It's better to see an specialist, and remember the different conditions of freediving.
   Hope that I helped you a little

 

[Erik]

Great people here! World record holders, yogis, and free medical advice from a freediving MD!
Que pasa bien, Frank:king

Warmly,
Erik Y.

 

[fpernett]

Lo mismo Erick,

 

[peterk]

hi Frank,
and thank you VERY MUCH for your
detailed answer!
quite a few things I did not know -

for instance:
it was a nice surprise
to read about the mammalian diving reflex,
(I am a devotee of all marine mammals
see my website)
even though that makes it harder on my heart now...

Since that Galapagos Free Dive
my angina pectoris went unstable
(not through freediving- )
with chest/shoulderpain and shortness of breath
off and on for six weeks
at the end 0f 2000

Though it was nowhere
near as scary as the intial attack at sea.

I 'feel' my heart occasionally, but it's
been quite good lately

I shall definetely heed your advice
about the stress EKG

De Nuevo: Muchisimas Gracias, Frank!
(Por los ultimos casi dos anos he estado en Arica, Chile)

I appreciate your effort, Erick!