Fitness

Can a coronary calcium scan improve the prediction of heart attacks in older divers?

In the July 2015 issue of Undercurrent, an article titled “A better heart-check tool than a stress test?” discusses the possible benefits of a coronary calcium scan for older divers to reduce the risk of experiencing a heart attack while diving.1 This article is a follow-up to a May 2015 Undercurrent report about an overweight 65-year-old diver who died shortly into his dive while on a dive trip.2 That article, which considered preventive options such as a stress test, also presented views from Dr. Alfred Bove and DAN’s Dr. Petar Denoble and Dr. James Chimiak, who agreed with the American College of Physicians (ACP) guidelines that recommend a graded and individualized approach to preventive testing and diagnostics.

Another physician suggests in the July 2015 article, however, that older divers should have a coronary calcium scan, which he claims may provide information that will help them avoid a heart attack on their dive trips. Many walk-in clinics offer the test at a low price. “A coronary calcium scan can tell you years before a positive stress test that you are headed in that direction [of significant coronary disease] so that you can do some kind of intervention,” he said. While the statement has merit, it may be misleading in this context.

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High-Fat Diet and Risk of Decompression Illness

dietObesity has been long considered a risk factor for decompression sickness (DCS). It has been based on findings in animal studies and epidemiological data in military diving. There was no data to confirm the same effects of obesity on incidence of DCS in recreational diving; however, there were some studies indicating a positive correlation between body mass index (BMI) and likelihood of venous gas emboli (circulating gas bubbles) after dive.

In a recent paper, Kaczerska D, et al. The influence of high-fat diets on the occurrence of decompression stress after air dives. UHM 2013;40(6):487-497, intended to test possible effects of high fat intake on risk of DCS.

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