acceptable limits of physical activities

  In 1976 our son, then 10, was found to have a "very mild valvular aortic stenosis" by a pediatric cardiologist prior to scheduled surgery to correct an abdominal hernia. In a letter, the cardiologist states, " I have requested that Michael participate in competitive athletics only to the extent involved in baseball or tennis. I would exclude him from competitive basketball or football. This does not in any way indicate that he should be made a cardiac cripple. He should be allowed to participate in any P.E. activities with the exception of running laps and he should be allowed to rest if he feels fatigue. Other than this, no restrictions are warranted concerning Michael's activities."  Now an adult, and working in Australia, he has informed me that he plans on scuba diving with friends at the Great Barrier Reef at the end of this month. Would this be an acceptable activity for one  with a "very mild valvular aortic stenosis" ? An opinion from a physician will certainly carry much more weight than one from his father. Thank you.

[CCF Cardio MD - MTR]

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Dear Brian, thank you for your question.  The question you ask about whether
your son could safely go scuba diving with mild aortic stenosis (AS) is a difficult
one to answer.  I did an extensive search of the medical literature and
cardiology textbooks and I could find no references on scuba diving, decompression
sickness, and aortic stenosis.  I've also consulted the cardiologists here who
specialize in treating patients with aortic stenosis.  The general consensus
appears to be that any patient with at least moderate AS should only engage
in light physical exercise.  The reason for those recommendations is that
with AS, there is a fixed obstruction to the ejection of blood from the left
ventricle.  During rest or light exertion, that obstruction usually doesn't
cause a problem but during exercise when the heart rate and cardiac output
increase, a fixed obstruction could cause loss of consciousness and more serious
problems.  It's hard to say how much exertion would be required to go scuba diving
and whether decompression sickness (the "bends") would be more common with AS.
Also, without examining your son and knowing the results of his echocardiogram,
I cannot confirm that he only has mild AS. Thus, your son should see a cardiologist
in Australia before starting scuba diving.  I hope you find this information
useful.
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.