Heart murmurs and diving etc...

January 19, 2007 12:15 PM

Whilst at the quack's for a check-up to do a diving course, he informed me I had a systolic heart murmur. I've googled (of course) but wondered if anyone else had experience so I can set my anxiety 'defcon' level appropriately! I have to have an 'echocardiogram'- potential problems for SCUBA? Thanks mefiers...
posted by Rufus T. Firefly to health & fitness (14 comments total)

Echocardiogram is the process of taking ultrasound photos/videos of the heart. It's just like what they do to look at the baby when a woman is pregnant, except they look at a heart instead of a womb - not scary at all. I can't imagine that it would cause any problems for SCUBA, but I've not no experience in that area. Not sure about the murmur, but I'm sure others will chime in.
posted by vytae at 1:01 PM on January 19, 2007

(. . . got no experience . . .)
posted by vytae at 1:03 PM on January 19, 2007

Um, one of my cats has a heart murmur. I only found out this year when he was 7. I can go have a bunch of expensive diagnostics done on him, but basically the vet just told me to watch him and bring him in if he has signs of obvious fatigue or is breathing very fast. He's good-natured, and plays and runs around, so I don't worry much about him. It is really scary to hear something's wrong with someone's heart, though, so I understand why you are worried. Just make sure you keep playing and running around as usual. (?)
posted by loiseau at 1:31 PM on January 19, 2007 [1 favorite]

I get annual echocardiograms due to my own heart murmur and related cardiac concerns. It's a very easy test -- you'll lie down, and a technician will run the probe (covered in ultrasound gel) over your chest to generate the images. It can last a few minutes or maybe longer, depending on what they're looking for and how clear the pictures are. There's no discomfort, though the gel might feel a little chilly at first if they don't keep the room warm enough, and sometimes they have to press a bit hard against your rib cage, which might feel a little tender for a minute. Getting an echo (and like I said, I've had a dozen or more over the years) is a piece of cake -- nothing to fret about, honestly.

I don't have any experience with heart murmurs and safety for diving, though of course I'm sure your doctor will let you know exactly what's safe and what isn't (I can't take part in contact sports, for example). Also, keep in mind that heart murmurs are "innocent" -- that is, they can exist without any need to restrict activities, etc. (IANAD!) So, again: no need to panic at this stage.
posted by scody at 1:33 PM on January 19, 2007

gah! read: "keep in mind that many heart murmurs are innocent..."
posted by scody at 1:34 PM on January 19, 2007

It's pretty minor to have a heart murmur, but one thing to keep in mind is to get antibiotics before major dental procedures. A stunning number of bacteria live in our mouths, and the "looseness" of a valve in a person with a heart murmur gives the bugs a great place to live. You really don't want to get an infection of the heart valves, as it could kill an otherwise healthy young person. This is a common precaution, but your dentist won't know about the murmur unless you tell them.
posted by selfmedicating at 1:46 PM on January 19, 2007

In my experience, echocardiograms are straightforward, completely comfortable 15-minute procedures. I have had a slight heart murmur since birth, evidently... mind you, this is so hard to detect that most of the docs I've ever mentioned it to have been unable to hear it. One particularly zealous primary care doctor did hear it a couple of years back, and then sent me for an electrocardiogram to make sure it wasn't a health concern.

When the technician and the medical resident had finished running the test and were looking over the results, I asked them if I had anything to be concerned about. The response was "everybody and their mother has a heart murmur; it's nothing to worry about."
posted by killdevil at 1:52 PM on January 19, 2007

I enjoyed the hell out of my echo, because holy crap! That's my heart on that little TV! Cool! So yeah, the test itself is nothing to worry about. I have a little murmur but all the followup tests were perfectly normal, so that's definitely a possibility.

You'll know when you get your results back how much you should be freaking out. However, being a freaker-outer myself, I recommend reminding yourself in the meantime that your doctor knows more about this than you or I do, so if he/she suspected something serious you probably wouldn't be taking these tests as an outpatient. Good luck.
posted by ultraultraboomerang at 2:00 PM on January 19, 2007

I enjoyed the hell out of my echo, because holy crap! That's my heart on that little TV!

Heh, me too -- if I can't see the screen, I always ask the technician to position it so I can watch. I think it's awesome.
posted by scody at 2:07 PM on January 19, 2007

SCUBA diver with a mild mitral valve prolapse here. This is a pretty common, if not the most common anatomical valve flaw of the human heart, basically created by the ligaments that stop the mitral valve flaps being a bit too long. So, the valve flaps can "overshoot" the closed condition, allowing leakage between the right atrium and right ventricle, causing less efficient pumping. This can get worse when the heart is pumping faster, under stress. But fortunately, mine is pretty minor, and presents no problem.

Still, you're getting a physical to be cleared for participation in a risky physical endeavor. The ocean is an interesting, but always hostile place, and your ability to control a situation is not always sufficient to keep you from experiencing high physical stress, perhaps well beyond what you experience on land, and you don't always have the luxury of just sitting down and resting. So, if your ticker isn't sound, it is better you find out about it, and consider fixing it if possible, while avoiding situations where excessive stress could lead to serious problems, or death.

Follow up with your referral to a cardiologist. IANAD, but from what I understand, chances are excellent you're one of millions of people with a noisy and somewhat inefficient heart valve, that will be able to do SCUBA, if you want.
posted by paulsc at 2:08 PM on January 19, 2007

Just nthing that the echo is nothing (I have two distinct heart murmurs so my doctors like to keep tabs), and is really kinda cool!
posted by trip and a half at 2:23 PM on January 19, 2007

If you have any leakage from the right to the left chambers of the heart you are much more likely to get the bends when you dive, Rufus T. Firefly. About 20% of the adult population does, from a PFO (Patent Foramen Ovale), an opening between the two atria of the heart which is necessary for the fetus because blood is not oxygenated by the lungs before birth, but which is supposed to close up right after you are born. It's also a risk factor for migraines, interestingly.

What you describe is not necessarily identical to a PFO, paulsc, but I cannot see how the ultimate effect could fail to be the same if it were bad enough, so please be a little less casual about the whole (sorry!) thing.
posted by jamjam at 4:20 PM on January 19, 2007

Paulsc, you have MVP and still SCUBA? Wow. Not that I'm disagreeing with you (you're obviously living proof), but a guy I knew in high school collapsed after diving and ultimately died. They said a bubble had gotten into his heart somehow due to his MVP. And when I was diagnosed with "textbook" MVP, I was told that I could not do SCUBA or sky dive (the latter being much more disappointing, in my opinion). So yeah, I guess to each his own, but I'd suggest that anyone with a murmur or MVP get cleared for diving by his or her doctor.

Also, ditto on the possibility of premedicating before dental stuff.
posted by Cochise at 7:46 PM on January 19, 2007

"... So yeah, I guess to each his own, but I'd suggest that anyone with a murmur or MVP get cleared for diving by his or her doctor. ..."

Always the sensible thing to do, and thanks for your concerns guys, but the docs who've done my annual and FAA flight physicals, including a cardiologist, over the last 10 years, agree with the SCUBA Doc. Something's gonna kill me for sure, but it's probably not going to be a problem with my mitral valve.
posted by paulsc at 9:05 PM on January 19, 2007