{"id":2195,"date":"2020-07-14T15:33:33","date_gmt":"2020-07-14T19:33:33","guid":{"rendered":"http:\/\/wordpress.world.dan.org\/?post_type=dan_health_resources&#038;p=2195"},"modified":"2020-09-17T12:00:42","modified_gmt":"2020-09-17T16:00:42","slug":"cardiovascular-drug-issues","status":"publish","type":"dan_health_resources","link":"https:\/\/world.dan.org\/fr\/health-medicine\/health-resource\/dive-medical-reference-books\/the-heart-diving\/cardiovascular-drug-issues\/","title":{"rendered":"Chapitre 7 : Questions relatives aux m\u00e9dicaments cardiovasculaires"},"content":{"rendered":"<p class=\"has-medium-font-size\"><em><strong>\u201cDivers who take drugs to treat cardiovascular diseases often worry about the drugs\u2019 compatibility with diving. However, in most cases, it is the underlying condition and not the drug that should cause concern.\u201d<\/strong><\/em><\/p>\n\n\n\n<p>Some drugs may have side effects that preclude diving. Divers should be very familiar with the side effects of any drugs they take and should discuss them with their physician \u2014 and be sure their physician knows about their diving activities. A one-time clearance to dive does not preclude progression of a disease, so any changes in your health status should prompt another medical examination before you dive again.<\/p>\n\n\n\n<p>Dans ce chapitre, vous apprendrez ce qui suit :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"#antiplatelets\">Antiplaquettaires et anticoagulants<\/a><\/li><li><a href=\"#statins\">Statines<\/a><\/li><li><a href=\"#antihypertensives\">Antihypertenseurs<\/a><\/li><li><a href=\"#antiarrhythmics\">Antiarythmiques<\/a><\/li><\/ul>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"antiplatelets\">Antiplaquettaires et anticoagulants<\/h2>\n\n\n\n<p>Antiplatelets and anticoagulants are two classes of drugs \u2014 popularly known as \u201cblood thinners\u201d \u2014 that reduce the risk of clot formation and thus the risk of deep vein thrombosis, pulmonary embolism, heart attack and stroke. They may also be prescribed for individuals who have been diagnosed with atrial fibrillation or for those who have had heart-valve surgery or who have received a stent, an implanted pacemaker or an implanted defibrillator. (See other sections for detailed descriptions of these conditions.)<\/p>\n\n\n\n<p>Les caillots se forment lorsque des cellules sanguines appel\u00e9es plaquettes s'agglutinent, puis que des prot\u00e9ines pr\u00e9sentes dans le sang les lient pour former une masse solide. La coagulation est une fonction normale qui limite et arr\u00eate les saignements lorsqu'un vaisseau sanguin est bless\u00e9. Toutefois, si un caillot se d\u00e9veloppe de mani\u00e8re incontr\u00f4l\u00e9e ou commence \u00e0 se d\u00e9placer dans le syst\u00e8me circulatoire, il repr\u00e9sente alors un danger. Les caillots peuvent se loger dans une art\u00e8re pulmonaire et provoquer une embolie pulmonaire, dans les art\u00e8res du c\u0153ur et provoquer une crise cardiaque, ou dans les vaisseaux du cerveau et provoquer un accident vasculaire c\u00e9r\u00e9bral. Tous ces \u00e9v\u00e9nements peuvent mettre la vie en danger.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignleft size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antiplatelet-anticoagulant-medicines-stethescope.jpg\" alt=\"St\u00e9thoscope rouge et m\u00e9dicaments anticoagulants\" class=\"wp-image-2197\" width=\"336\" height=\"225\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antiplatelet-anticoagulant-medicines-stethescope.jpg 512w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antiplatelet-anticoagulant-medicines-stethescope-360x241.jpg 360w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/antiplatelet-anticoagulant-medicines-stethescope-18x12.jpg 18w\" sizes=\"auto, (max-width: 336px) 100vw, 336px\" \/><\/figure><\/div>\n\n\n\n<p>Les antiplaquettaires et les anticoagulants emp\u00eachent le sang de coaguler aussi rapidement ou efficacement que d'habitude en emp\u00eachant les plaquettes d'adh\u00e9rer les unes aux autres et en emp\u00eachant les prot\u00e9ines de coagulation de se lier entre elles. Ils peuvent m\u00eame aider \u00e0 briser les caillots d\u00e9j\u00e0 form\u00e9s.<\/p>\n\n\n\n<p><strong>Antiplaquettaires<\/strong> \u2014 such as aspirin and clopidogrel (also known by the brand name Plavix) \u2014 work by preventing the platelets from adhering to one another.<\/p>\n\n\n\n<p><strong>Anticoagulants<\/strong> \u2014 such as heparin and warfarin (Coumadin) \u2014 inhibit the action of the clotting proteins and thus slow down the chemical reactions that lead to the formation of a clot. There were also several new anticoagulants approved between 2010 and 2012, including rivaroxaban (Xarelto), dabigatran (Pradaxa) and apixaban (Eliquis).<\/p>\n\n\n\n<p>The major side effect of all antiplatelets and anticoagulants is excessive bleeding. Those taking such drugs \u2014 especially at too high a dosage \u2014 may bleed or bruise easily or may experience bleeding that does not stop as quickly as usual.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Pr\u00e9cautions particuli\u00e8res concernant la warfarine<\/h4>\n\n\n\n<p>Individuals who take warfarin (Coumadin) are generally advised to avoid any activities that may cause abrasions, bruising or cuts \u2014 such as contact sports. They are also urged to exercise caution while brushing their teeth and shaving. Even such trivial injuries as insect bites may cause complications in anyone taking warfarin.<\/p>\n\n\n\n<p>There are additional risks involving warfarin particular to diving. Most significantly, there is an appreciable chance of serious injury in any diving environment, despite one\u2019s best efforts to mitigate the risk. Cuts and bruises are unavoidable, for example. And in anyone taking warfarin, a decompression injury or difficulty equalizing ear pressure could cause bleeding in the ears or the spinal cord that would otherwise not occur.<\/p>\n\n\n\n<p>En outre, les voyages et les perturbations alimentaires qui en r\u00e9sultent peuvent interf\u00e9rer dangereusement avec l'action de la warfarine. En outre, les capacit\u00e9s de soins de sant\u00e9 dans de nombreuses destinations de plong\u00e9e populaires peuvent ne pas \u00eatre \u00e0 la hauteur des soins qui seraient n\u00e9cessaires en cas d'\u00e9v\u00e9nement ind\u00e9sirable.<\/p>\n\n\n\n<p>Pour toutes ces raisons, il est g\u00e9n\u00e9ralement conseill\u00e9 \u00e0 toute personne prenant de la warfarine de ne pas plonger. N\u00e9anmoins, de nombreuses personnes qui prennent de la warfarine sont capables de plonger sans complications majeures. La cl\u00e9 pour plonger en toute s\u00e9curit\u00e9 lorsqu'on prend de la warfarine est de respecter scrupuleusement les analyses sanguines mensuelles et d'\u00eatre suivi r\u00e9guli\u00e8rement par un m\u00e9decin. Avec un bon contr\u00f4le de l'anticoagulation, le risque de complication h\u00e9morragique est assez faible.<\/p>\n\n\n\n<p>According to Dr. Alfred Bove, a dive-medicine specialist, \u201cFor divers, the most important question is whether the condition that requires the use of Coumadin or Plavix prohibits diving. In many cases, the illness is over, or chronic but well adjusted, and does not interfere with safe recreational diving. Safe diving with Coumadin or Plavix depends on the absence of illness that would limit diving, careful control of clotting time, avoiding ear or sinus squeeze, and a thorough education on drugs and foods which cause changes in the effects of Coumadin. There are many divers using Coumadin and Plavix safely, but a special effort must be made to understand how to avoid problems of excess or not enough anticoagulation.\u201d<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"statins\">Statines<\/h2>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"256\" height=\"256\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/statin-medications-000047026368-DAN-256x256-1.jpg\" alt=\"\" class=\"wp-image-11659\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/statin-medications-000047026368-DAN-256x256-1.jpg 256w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/statin-medications-000047026368-DAN-256x256-1-150x150.jpg 150w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/statin-medications-000047026368-DAN-256x256-1-12x12.jpg 12w\" sizes=\"auto, (max-width: 256px) 100vw, 256px\" \/><\/figure><\/div>\n\n\n\n<p>Statins are a class of drugs prescribed to lower high blood cholesterol and thus prevent heart attack and stroke. They reduce both LDL cholesterol (\u201cbad cholesterol\u201d) and inflammation in the arteries. Statins work by inhibiting a liver enzyme that is involved in the production of cholesterol. Though they are most effective at lowering LDL cholesterol, they may also contribute to raising HDL cholesterol (\u201cgood cholesterol\u201d).<\/p>\n\n\n\n<p>Common statins include the following \u2014 listed first by their generic name and, in parentheses, their brand name:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Atorvastatine (Lipitor)<\/li><li>Cholestipol (Cholestid)<\/li><li>Chlorhydrate de colesevalam (Welchol)<\/li><li>Fluvastatine (Lescol)<\/li><li>Lovastatine (Mevacor)<\/li><li>Ez\u00e9timibe (Zetia)<\/li><li>Ez\u00e9timibe associ\u00e9 \u00e0 la simvastatine (Vytorin)<\/li><li>F\u00e9nofibrate (Tricor)<\/li><li>Pravastatine (Pravachol)<\/li><li>Rosuvastatine (Crestor)<\/li><li>Simvastatine (Zocor)<\/li><\/ul>\n\n\n\n<p>Les essais cliniques parrain\u00e9s par les entreprises qui fabriquent ces m\u00e9dicaments ont r\u00e9v\u00e9l\u00e9 des effets secondaires rares et b\u00e9nins. Cependant, dans un essai soigneusement con\u00e7u, appel\u00e9 IDEAL, pr\u00e8s de 90 % des sujets ont signal\u00e9 des effets secondaires, dont pr\u00e8s de la moiti\u00e9 \u00e9taient graves. Les effets ind\u00e9sirables des statines qui ont \u00e9t\u00e9 relev\u00e9s dans la litt\u00e9rature m\u00e9dicale et qui pourraient interf\u00e9rer avec la plong\u00e9e sont les suivants :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Dyspn\u00e9e (g\u00eane ou difficult\u00e9 \u00e0 respirer)<\/li><li>Douleurs musculaires<\/li><li>Complications du tendon<\/li><li>Probl\u00e8mes digestifs<\/li><li>\u00c9ruption cutan\u00e9e ou bouff\u00e9es vasomotrices<\/li><li>Augmentation de la glyc\u00e9mie ou diab\u00e8te de type 2<\/li><li>Dysfonctionnement cognitif (certaines \u00e9tudes rapportent que jusqu'\u00e0 75 % des personnes sous statines ont pr\u00e9sent\u00e9 un dysfonctionnement cognitif jug\u00e9 probablement ou certainement li\u00e9 au traitement par statines ; la gravit\u00e9 des d\u00e9ficits cognitifs \u00e9tait clairement li\u00e9e \u00e0 la puissance des statines).<\/li><li>Fatigue (pr\u00e8s de la moiti\u00e9 des personnes interrog\u00e9es dans le cadre d'une \u00e9tude r\u00e9alis\u00e9e en 2012 ont fait \u00e9tat d'une augmentation significative de la fatigue li\u00e9e \u00e0 la prise de statines).<\/li><\/ul>\n\n\n\n<p>L'effet secondaire le plus courant des statines est la douleur musculaire. Elle survient chez environ 20 % des personnes prenant des statines. Ces douleurs peuvent prendre la forme de courbatures, de douleurs, de fatigue ou de faiblesse musculaire. La douleur est parfois d\u00e9crite comme une l\u00e9g\u00e8re g\u00eane, mais elle est parfois suffisamment grave pour rendre les activit\u00e9s quotidiennes difficiles. Les scientifiques pensent que l'apparition de la douleur est due au fait que les statines bloquent la production d'une mol\u00e9cule utilis\u00e9e par l'organisme pour g\u00e9n\u00e9rer de l'\u00e9nergie, appel\u00e9e CoQ10 ; des essais cliniques sont actuellement en cours pour d\u00e9terminer si la prise de suppl\u00e9ments de CoQ10 peut pr\u00e9venir cet effet secondaire. La prise syst\u00e9matique de suppl\u00e9ments de CoQ10 n'est toutefois pas recommand\u00e9e, m\u00eame si elle ne pose gu\u00e8re de probl\u00e8mes de s\u00e9curit\u00e9.<\/p>\n\n\n\n<p>Dans de tr\u00e8s rares cas, les statines peuvent entra\u00eener une sorte de l\u00e9sion musculaire potentiellement mortelle appel\u00e9e rhabdomyolyse ; elle provoque des douleurs musculaires intenses et peut entra\u00eener des l\u00e9sions h\u00e9patiques, une insuffisance r\u00e9nale et la mort. La rhabdomyolyse est particuli\u00e8rement susceptible de se produire chez les personnes qui prennent des statines en association avec d'autres m\u00e9dicaments tels que des antibiotiques et des antid\u00e9presseurs, ou chez celles qui prennent une dose \u00e9lev\u00e9e de statines.<\/p>\n\n\n\n<p>Certaines personnes qui prennent des statines peuvent avoir des naus\u00e9es, des gaz, des diarrh\u00e9es ou de la constipation. Ces effets secondaires sont rares.<\/p>\n\n\n\n<p>Une \u00e9ruption cutan\u00e9e ou des bouff\u00e9es de chaleur peuvent \u00e9galement survenir apr\u00e8s la prise d'une statine. Ce ph\u00e9nom\u00e8ne est plus susceptible de se produire chez les personnes qui prennent une statine et de la niacine ensemble, soit dans une pilule combin\u00e9e telle que Simcor, soit dans deux m\u00e9dicaments distincts.<\/p>\n\n\n\n<p>The FDA warns on statin labels that some people taking statins have developed memory loss or confusion; these effects are reversed when the medication is halted. Conversely, there has also been evidence that statins may help with brain function \u2014 in patients with dementia or Alzheimer\u2019s, for example. This effect is still being studied.<\/p>\n\n\n\n<p>Mais quels que soient les effets secondaires que les personnes prenant des statines peuvent ressentir, il est important qu'elles n'arr\u00eatent pas de prendre le m\u00e9dicament sans en parler \u00e0 leur m\u00e9decin. Il est \u00e9galement important que les personnes qui prennent des statines minimisent les changements dans leur mode de vie, leur r\u00e9gime alimentaire et les m\u00e9dicaments en vente libre, en particulier pendant les voyages li\u00e9s \u00e0 la plong\u00e9e.<\/p>\n\n\n\n<p>Les facteurs de risque des effets secondaires des statines sont les suivants :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Prise de plusieurs m\u00e9dicaments hypocholest\u00e9rol\u00e9miants<\/li><li>\u00catre \u00e2g\u00e9 de 65 ans ou plus, \u00eatre une femme ou avoir une plus petite corpulence<\/li><li>une maladie des reins ou du foie ou un diab\u00e8te de type 1 ou 2<\/li><li>Boire trop d'alcool (plus de deux verres par jour pour les hommes de 65 ans et moins ou plus d'un verre par jour pour les femmes de tous \u00e2ges et les hommes de plus de 65 ans).<\/li><\/ul>\n\n\n\n<p>En outre, les probl\u00e8mes sont plus probables chez les personnes qui prennent \u00e0 la fois des statines et les m\u00e9dicaments suivants :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Les antipalud\u00e9ens, tels que la chloroquine et l'hydroxychloroquine (Plaquenil).<\/li><li>M\u00e9dicaments pour la thyro\u00efde<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Effet sur la plong\u00e9e<\/h3>\n\n\n\n<p>Bien que les effets secondaires de certaines statines puissent interf\u00e9rer avec la plong\u00e9e, elles peuvent n\u00e9anmoins avoir des effets b\u00e9n\u00e9fiques sur la sant\u00e9 en g\u00e9n\u00e9ral.<\/p>\n\n\n\n<p>One of the effects of statins is an increase in the body\u2019s production of nitric oxide. This helps to preserve the integrity of the endothelium (the inner lining of the blood vessels), to reduce injury from ischemia and\/or reperfusion (a procedure that restores circulation after a heart attack or stroke) and to depress interdependent inflammatory and coagulation activity \u2014 all of which could provide protection against decompression sickness (DCS). On the other hand, a study of healthy divers who took either a statin or a placebo several days before a dive found no difference in their risk of postdive venous gas bubbles. Thus taking statins specifically to prevent DCS does not appear to offer any benefit, especially in view of the possibility of adverse side effects.<\/p>\n\n\n\n<p>If you are over age 45 and are already taking statins for medical reasons, you need to answer \u201cyes\u201d to at least two questions on the Recreational Scuba Training Council (RSTC) Medical Statement (see the \u201cPhysical Activity Recommendations\u201d section for details regarding this form):<\/p>\n\n\n\n<p>Q : Prenez-vous actuellement des m\u00e9dicaments sur ordonnance ? (\u00e0 l'exception des contraceptifs et des antipalud\u00e9ens) ?<\/p>\n\n\n\n<p>Q : Avez-vous plus de 45 ans et pouvez-vous r\u00e9pondre OUI \u00e0 une ou plusieurs des questions suivantes ?<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Avoir un taux de cholest\u00e9rol \u00e9lev\u00e9<\/li><\/ul>\n\n\n\n<p>Ces deux r\u00e9ponses positives signalent une condition pr\u00e9existante qui peut affecter votre s\u00e9curit\u00e9 pendant la plong\u00e9e et qui n\u00e9cessite un examen m\u00e9dical approfondi pour v\u00e9rifier la pr\u00e9sence d'autres facteurs de risque ou de signes de maladie cardiovasculaire. En effet, toute personne \u00e2g\u00e9e de plus de 45 ans, pr\u00e9sentant un risque \u00e9lev\u00e9 de probl\u00e8mes cardiaques ou des signes de maladie cardiovasculaire devrait consulter un m\u00e9decin au moins une fois par an.<\/p>\n\n\n\n<p>Il convient \u00e9galement de noter qu'une autorisation unique de plonger n'emp\u00eache pas l'\u00e9volution d'une maladie, de sorte que tout changement de votre \u00e9tat de sant\u00e9 doit entra\u00eener un nouvel examen m\u00e9dical avant de plonger \u00e0 nouveau. Les plongeurs doivent \u00e9galement \u00eatre conscients du fait qu'ils peuvent \u00eatre amen\u00e9s \u00e0 remplir une nouvelle d\u00e9claration m\u00e9dicale du RSTC avant toute plong\u00e9e et que l'autorisation de plonger peut leur \u00eatre refus\u00e9e sur la base de leurs r\u00e9ponses. Toutefois, la plupart des op\u00e9rateurs de plong\u00e9e acceptent la preuve d'un certificat m\u00e9dical r\u00e9cent pour la plong\u00e9e. Si vous avez le moindre doute sur votre aptitude \u00e0 plonger, discutez-en \u00e0 l'avance avec votre organisateur de plong\u00e9e.<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"antihypertensives\">Antihypertenseurs<\/h2>\n\n\n\n<p>Il existe un certain nombre de m\u00e9dicaments qui peuvent \u00eatre utilis\u00e9s pour r\u00e9duire l'hypertension (\u00e9galement appel\u00e9e pression art\u00e9rielle \u00e9lev\u00e9e). Leurs effets secondaires varient, de sorte que certains conviennent mieux que d'autres aux plongeurs.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">B\u00eata-bloquants<\/h3>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignleft size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"256\" height=\"171\" src=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/beta-blockers-antihypertensives-000007422818-DAN-256x171-1.jpg\" alt=\"\" class=\"wp-image-11660\" srcset=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/beta-blockers-antihypertensives-000007422818-DAN-256x171-1.jpg 256w, https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/beta-blockers-antihypertensives-000007422818-DAN-256x171-1-18x12.jpg 18w\" sizes=\"auto, (max-width: 256px) 100vw, 256px\" \/><\/figure><\/div>\n\n\n\n<p>Beta blockers are commonly prescribed to treat hypertension, but they have a big drawback for divers: They can reduce the heart\u2019s capacity for exercise. If a medication restricts the heart\u2019s function during exercise, then there is an increased risk of loss of consciousness, which could prove fatal while diving.<\/p>\n\n\n\n<p>Because of this effect, doctors often recommend that those who take beta blockers undergo a stress test before diving. According to Dr. Alfred Bove, a dive-medicine specialist, divers who take beta blockers but who can achieve a strenuous level of exercise without severe fatigue can be cleared for diving. Bove also points out that although diving does not usually represent the maximum workload on an individual\u2019s heart, anyone who takes beta blockers should avoid extreme exercise because their maximum exercise capacity may be reduced.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Inhibiteurs de l'ECA<\/h3>\n\n\n\n<p>Drugs known as ACE (angiotension-converting enzyme) inhibitors have less effect on exercise capacity than beta blockers, so many doctors prescribe them for people who exercise frequently. But although ACE inhibitors seem to have fewer adverse effects, they can lead to a cough or to airway swelling \u2014 conditions that could cause severe problems underwater. If a cough related to ACE-inhibitor use persists, many physicians will recommend a different medication. ACE inhibitors should also be avoided by anyone with kidney disease.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Bloqueurs du canal calcique<\/h3>\n\n\n\n<p>Calcium channel blockers don\u2019t typically pose problems for divers; they relax the walls of the blood vessels, reducing resistance to the flow of blood and thus lowering blood pressure. However, some individuals who take calcium channel blockers, especially in moderate doses, find that a change of position from sitting or lying down to standing causes a drop in blood pressure and thus momentary dizziness. This effect may be cause for concern in divers, but calcium channel blockers appear to have no other adverse implications for diving.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Diur\u00e9tiques<\/h3>\n\n\n\n<p>Diuretics reduce the amount of excess water and salt in the body; the decline in the volume of bodily fluids results in a lowering of the blood pressure. Divers seem to have very little trouble with diuretics, although in very warm environments, they may cause excessive water loss and thus dehydration. Because dehydration seems to contribute to the risk of decompression sickness, divers may want to reduce their diuretic dosage on days that they engage in diving \u2014 though they should check with their doctor before doing so.<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"antiarrhythmics\">Antiarythmiques<\/h2>\n\n\n\n<p>Les antiarythmiques sont con\u00e7us pour aider le c\u0153ur \u00e0 maintenir un rythme stable. Le Dr Alfred Bove, sp\u00e9cialiste de la m\u00e9decine de plong\u00e9e, avertit que certains antiarythmiques, lorsqu'ils sont associ\u00e9s \u00e0 l'exercice physique et \u00e0 une baisse du taux de potassium, peuvent augmenter le risque de l\u00e9sions cardiaques. Bien que ces m\u00e9dicaments n'interf\u00e8rent normalement pas avec la plong\u00e9e, l'arythmie pour laquelle le m\u00e9dicament est pris peut elle-m\u00eame emp\u00eacher la pratique de la plong\u00e9e en toute s\u00e9curit\u00e9. Une consultation approfondie avec un cardiologue et un sp\u00e9cialiste de la m\u00e9decine de plong\u00e9e est essentielle si vous prenez des m\u00e9dicaments pour contr\u00f4ler un rythme cardiaque anormal et que vous souhaitez envisager de plonger.<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"has-text-align-right\"><strong>Suivant : <a href=\"https:\/\/world.dan.org\/fr\/health-medicine\/health-resource\/dive-medical-reference-books\/the-heart-diving\/further-reading-and-sources\/\">Lectures compl\u00e9mentaires et sources &gt;<\/a><\/strong><\/p>","protected":false},"excerpt":{"rendered":"<p>&#8220;Divers who take drugs to treat cardiovascular diseases often worry about the drugs&#8217; compatibility with diving. However, in most cases, it is the underlying condition and not the drug that [&hellip;]<\/p>\n","protected":false},"featured_media":11658,"parent":2110,"menu_order":28,"template":"","dan_health_resource_types":[405],"class_list":["post-2195","dan_health_resources","type-dan_health_resources","status-publish","has-post-thumbnail","hentry","dan_health_resource_types-dive-medical-reference-books"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Chapter 7: Issues Involving Cardiovascular Drugs - DAN World<\/title>\n<meta name=\"description\" content=\"Divers should be very familiar with the side effects of any cardiovascular drugs they take and should discuss them with their physician.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/world.dan.org\/fr\/health-medicine\/health-resource\/dive-medical-reference-books\/the-heart-diving\/cardiovascular-drug-issues\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Chapter 7: Issues Involving Cardiovascular Drugs\" \/>\n<meta property=\"og:description\" content=\"Divers should be very familiar with the side effects of any cardiovascular drugs they take and should discuss them with their physician.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/world.dan.org\/fr\/health-medicine\/health-resource\/dive-medical-reference-books\/the-heart-diving\/cardiovascular-drug-issues\/\" \/>\n<meta property=\"og:site_name\" content=\"DAN World\" \/>\n<meta property=\"article:modified_time\" content=\"2020-09-17T16:00:42+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/world.dan.org\/wp-content\/uploads\/2020\/07\/cardiovascular-drugs-issues-204192469-DAN-1200x700-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"700\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"12 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/world.dan.org\\\/health-medicine\\\/health-resource\\\/dive-medical-reference-books\\\/the-heart-diving\\\/cardiovascular-drug-issues\\\/\",\"url\":\"https:\\\/\\\/world.dan.org\\\/health-medicine\\\/health-resource\\\/dive-medical-reference-books\\\/the-heart-diving\\\/cardiovascular-drug-issues\\\/\",\"name\":\"Chapter 7: Issues Involving Cardiovascular Drugs - 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