Should a history of venous thromboembolism be considered a contraindication for scuba diving?
Mathilde Vannini 1); Jean-François Schved 2); David M. Smadja 1), 3), 4); Viktoria E.M. Jung 5); Laetitia Mauge 1), 6); Olivier Sanchez 3), 4), 7); Nicolas Gendron 1), 3), 4)
1) Hematology Department, Assistance Publique – Hôpitaux de Paris-Centre Université de Paris, Paris, France
2) Université de Montpellier, Montpellier, France
3) Innovative Therapies in Haemostasis, INSERM, Université Paris Cité, Paris, France
4) F-CRIN INNOVTE, Saint-Étienne, France
5) Department of Rheumatology and Clinical Immunology, Universitätsklinikum Freiburg, Freiburg, Germany
6) Paris Cardiovascular Research Center, INSERM, University Paris Cité, Paris, France
7) Respiratory Medicine Department, Assistance Publique – Hôpitaux de Paris-Centre Université Paris Cité, Paris, France
Abstract
The question of whether scuba diving is safe for patients with a history of venous thromboembolism (VTE) remains unanswered. Cases of VTE have been reported after decompression accidents but not following properly conducted dives. However, the risk of VTE and bleeding on anticoagulant therapy during diving has yet to be defined. Medical diving societies make different recommendations regarding the risk of scuba diving in patients with a history of VTE and/or hereditary thrombophilia and regarding the bleeding risk under anticoagulation associated with dives. There is no epidemiologic or pathophysiologic evidence described in the literature to support a direct association between VTE and diving. Therefore, VTE cannot be considered as a definite contraindication for scuba diving. Further studies are needed to conclusively establish the risk of VTE associated with diving and to guide the development of medical guidelines by diving societies.