CAD and parachutes

You’ve meticulously packed your main; you’ve set your automatic activation device; you’ve reviewed your emergency procedures and landing pattern; you’ve done a final pin check in the plane; and you feel confident all will go well. You know that a skydiving accident could kill you in an instant... but so can a heart attack. Are you just as meticulous about your health?

Since 1999, statistics show that 17 skydiving fatalities were directly attributable to medical events during the jumps. On top of that, medical issues were quite likely the root cause of many other fatalities about which investigators were unable to make definitive determinations. Cardiovascular disease (CVD) is the most common cause of death for both men and women in the U.S., causing about 2,200 deaths per day. Unfortunately, we are seeing more and more of our fellow skydivers dying—whether in the air or on the ground—from CVDs, in particular, Coronary Artery Disease (CAD).

The coronary arteries are the blood vessels that supply the heart with oxygen and nutrients. It’s the blockage in these blood vessels that causes a heart attack. The same is true with blood vessels elsewhere in the body: Block a vessel to the brain, and it causes a stroke; block an artery in the leg, and it can cause loss of that leg. If you have no symptoms, you may not be concerned, but bear in mind that poor blood supply to a certain male organ often causes impotence. Now are we paying attention?

A large proportion of CVD is preventable, and for some people, it is even reversible. However, most people do not show symptoms until they have a blockage of at least 60 percent. Unfortunately, this means that the first sign of CAD is often a heart attack or sudden death. So, it is highly likely that some of the mysterious no-pull fatalities in the past few decades were due to a heart attack, even though relatives and friends might have stated that the person was in perfect health prior to the jump. As an emergency room doctor, I can state that more than half of the heart-attack patients I’ve treated had no prior symptoms.

It is important to understand that CAD is not a disease of the elderly; it actually starts very early in life. It takes years to build up the plaque in the arteries that will eventually cause a heart attack. To avoid a heart attack, you must be proactive with your health. Risk factors for CAD include smoking, elevated cholesterol (especially elevated LDL cholesterol), high blood pressure, diabetes, a family history of CAD and being overweight. Certainly, if you are having symptoms of CAD—any type of discomfort in your chest, back, arms or jaw (especially while doing anything that increases your heart rate), shortness of breath with exertion or an increase in fatigue with exertion—you need to see your doctor.

So, what can you do to minimize your risk? First, see your doctor for a risk assessment. He should be able to help mitigate your risk by providing recommendations for medications such as aspirin, as well as provide information about changing your lifestyle. On the other hand, don’t just rely on your doctor to cure you or prevent you from having a heart attack. A lot of it is up to you. Here are some steps you can take, whether or not you already know you have CAD:

• Eat a healthy diet that is high in complex carbohydrates and lots of fiber.
• Get plenty of exercise, at least 30 minutes daily.
• Stop smoking.
• Eat mostly whole foods that have been processed as little as possible.
• Limit your salt intake to less than one teaspoon (about 2,000 mg of sodium) daily.
• Eat a low-fat diet, with less than 15 to 20 percent of your calories from fat.

Minimizing an adverse event also takes a proactive approach. An AAD could very well save the life of a jumper who has a heart attack in freefall. DZ seminars on CPR, first aid and the use of an automated external defibrillator that shocks the heart back into beating could save lives (the odds of surviving a heart attack decrease 7 to 10 percent per minute without treatment). Jumpers may even want to consider looking their fellow skydivers in the eye as part of the pin check to make sure everything looks OK. If someone looks as if he might need rapid medical care, abort the jump. Additionally, if you know you have CAD and are on a blood thinner such as Coumadin® (warfarin), Plavix® or Pradaxa®, then you shouldn’t be jumping at all (as you probably well know).

Skydivers enjoy living life to the fullest. So if you’d like to be able to keep jumping well into your 60s, 70s, 80s and beyond, take care of yourself. Living a long and healthy life is something we all want. Healthy skies.

—Dr. Larry Cohen | C-10003Director of the Coronary Health
Improvement Project

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