Coronary bypass

I was VERY luck! I had major blockage of five coronary arteries, but didn't know it! I had an excellent, conservative Internist who had a "hunch" and sent me in for a exercise stress test, despite the fact that my age at the time (49) did not necessarily call for the test, my cholesterol level was "borderline", and I was in good physical condition. I had NO symptoms. A subsequent heart catheterization indicated five blockages and I successfully underwent and recovered from surgery for five bypasses. This summer I decided that I wanted to learn to dive (at the age of 52!). Getting my Internist and Cardiologist to sign my medical form involved QUITE a discussion! It appeared that their reluctance to sign stemmed from two issues: 1) A lack of available medical knowledge concerning SCUBA diving and individuals who have undergone CABG; 2) A lack of information concerning how to discuss the limitation of risk for such divers. I was able to convince both my doctors to sign my medical fitness document. I had METs of 14 and was able to swim the 400 yards required by my Instructor and to tread water for 10 minutes. I advised my doctors that until I received better information, I would limit my dives to shallower depths (60 ft. or less) and warm water (no less than 60 degrees). I agreed not to do any wreck diving nor would I do any "work" under water. This arrangement is fine with me.
My question to your journal relates to the information that you provide.
As I read the information, the risks you present relate to persons who have UNDIAGNOSED Coronary Artery Disease (CAD) and the number of cases of death related to that undiagnosed disease. Is there any available information concerning diagnosed and treated individuals who have CAD? Is there any medical information concerning limitation of risks for such individuals.
Should there be differences in limitations for people who have had CABGs?
I would be interested in assisting to develop such information.

To my knowledge there have been no studies of the nature that you describe.
Patients who have had successful coronary bypass surgery, angioplasty or stents who wish to undertake sport diving should generally be allowed to participate in this activity. Within the limits of the history that you provide, you should be able to resume diving without making any major changes in your life style. As you probably have been told, you need to keep your weight and blood pressure under control and maintain an exercise program. However, you must be guided by the findings and opinions of your doctors who are responsible for your well-being.
In deciding whether to dive, there should be a regular review of coronary anatomy and degree of vascularization of the damaged portions of your heart.
An exercise tolerance (exercise test) study should be undertaken. If you can exercise with no ischemia (decreased blood supply), or angina (chest pain), normal blood pressure response, and no serious heart irregularity (arhythmia), limited sport diving may be considered. Limited sport diving involves warm water (3 mm wet suit), shallow depths (60 fsw/18.3 m.) and minimal currents with easy entry and exits. A good source about diving with cardiovascular disease is the text 'Diving Medicine', AA Bove, Editor. He is a premier cardiologist at Temple University in Philadelphia and if you need a second opinion, he would be an excellent choice.
Your personal physician should be the final arbiter in making the decision as to diving.
More information about coronary disease, exercise and heart problems relatedto diving can be found at: