Atherosclerosis and coronar heart disease

Chronic diseases known to be of higher incidence in the elderly present special problems in diving. A significant and important problem in the elderly is the high incidence of cardiovascular disease. Atherosclerosis can affect flow to the brain, heart. kidneys, or skeletal muscles. These disorders may go undetected and high exercise demands induced by swimming with diving gear may result in inadequate oxygen supply and abnormal function of a tissue or organ. Of most importance is the presence of coronary atherosclerosis with coronary artery disease, heart attack or sudden death may occur in unfit divers with coronary disease.

In the presence of increased work demands, the heart becomes oxygen starved. There are several consequences of inadequate oxygen supply to the heart during diving. Oxygen deprived heart muscle may develop sudden reduction in pumping function.. Marked shortness of breath and lung congestion will occur with exercise.

Although coronary heart disease is usually manifested by chest pain in most afflicted people, the most troublesome person with coronary disease is the person who has no symptoms but who develops marked oxygen deprivation detected only by electrocardiogram. Such people are at greater risk for sudden death since they developed no premonitory symptoms when oxygen deprivation to the heart occurs.

Symptoms of angina pectoris, history or finding of myocardial infarction arrhythmias due to coronar heart disease , represent in most cases contraindications to diving.