Rocky couldn’t think of any place he would rather be than ­underwater. Fresh off a retirement celebration, Rocky took up the second hobby of ­shooting underwater video to show nondivers ­exactly what they’re missing.

The water was cold, but it was clear and the sun was shining brightly above him. That made it a perfect day to video the kelp forest. There was a gentle wave action causing the kelp to sway back and forth, setting up a picturesque scene.

It was Rocky’s fourth dive of the day, and he was tired. He didn’t have the energy to dive all day like he used to, but this seemed worse than normal. He made his way toward the ladder to climb back onto the pier and took off his fins for the climb. Rocky felt the weight of his gear as soon as he rose out of the water, but he still had several more steps to go before he reached the top of the ladder. He wasn’t sure he could make it.

The Diver

Rocky was 77 years old and had been a diver for more than 40 years. He remembered the days of double-hose regulators and ­divers ­wearing Mae West vests instead of modern BCs.

He was a dive instructor, although he had let that lapse in recent years, deferring to younger instructors to train the next generation of divers. Rocky still enjoyed teaching, but he preferred to use his ­retirement years to really enjoy the ocean for himself.

The Dive

The dive site was relatively shallow, only 30 to 40 feet deep, but Rocky made four dives, with moderate surface intervals between each one. He was working on a video project about the beauty of the ­local kelp forest.

The Accident

Climbing out of the water, Rocky felt weak. There was a pounding in his chest and he felt cold. He climbed out of the water and looked up. There were still five rungs on the ladder before he would reach the top. He wasn’t sure he could make it. Before he could say anything, he lost consciousness and fell backward into the water in full gear. He narrowly missed his dive buddy, who was about to begin the climb as well. Rocky’s buddy thought he ­simply slipped but quickly realized Rocky was unconscious. He yelled for help from other divers on the pier, and then grabbed Rocky and turned him face up. He checked for signs of breathing but didn’t find anything. He immediately began stripping Rocky out of his dive gear, and the other divers helped drag Rocky out of the water and onto the pier. They began cardiopulmonary resuscitation, but Rocky never recovered.

Analysis

The medical examiner determined Rocky had severe atherosclerosis of the coronary arteries, an abdominal ­aortic aneurysm, pulmonary ­emphysema, cardiomegaly (enlarged heart), and ­atherosclerosis of the arteries at the base of the brain. The cause of death was ruled an acute cardiac event.

More than 40 percent of all dive ­fatalities have nothing to do with diving at all but instead are related to the heart. Strokes and heart attacks are now the second leading cause of death for ­scuba divers, after drowning. Cardiac issues are now a leading factor in diving fatalities, according to Dr. Peter Buzzacott of the University of Western Australia, who recently released a study on dive fatalities published in the European Journal of Preventive Cardiology.

Read More: Lessons for Life

Cardiac events can happen anywhere — at the mall, at home or wherever. The physical work of diving contributes to the heart attack, as does the location where the cardiac event takes place. If you are on a beach or a dive boat when you have a heart attack, your chances of survival are lower than if you are in town around people. That is simply a factor of the first responders’ ability to get to you in time and begin treatment.

Outwardly, Rocky appeared to be in good health for a 77-year-old. He wasn’t overweight, and he remained active. In his case, considering the host of cardiac problems ­discovered on autopsy, it is likely that no amount of field medical care could have saved Rocky’s life.

There are risk factors for heart disease, including smoking, obesity, high cholesterol and sedentary lifestyles. However, some people have high incidences of heart disease even without those risk factors. That is why it is important to consult your physician regularly and make sure you are fit enough to dive.

There is no age at when you must stop diving. There are many divers who dive much later than Rocky did, while others hang up their fins earlier. The important question is fitness. Are you fit enough to carry your gear, swim at an acceptable pace, and carry out the work of the dive? That includes retaining the exercise capacity to respond to an emergency.

The only way to assess this is an ­annual physical from a physician, preferably one who understands the needs of a diver. If there is a potential problem, a cardiac stress test is the best diagnostic tool to assess your heart health. Finding out you have heart disease is not a final determination that you can or can’t dive. You just have to fix the problem and work your way back to the water. Divers who have known heart disease are required to perform rigorous exercise on a treadmill without problems. This test, called the Bruce ­Protocol, involves increasing intensity up to 4.2 mph at 16 percent grade for three minutes. Diving doctors say they wish all divers could exercise to that ­level, but they are unable to enforce it.

Lessons for Life

• Talk to your doctor. As you get older, ­consult your doctor regularly to make sure you are fit enough to dive. Don’t assume anything.
• Quit smoking. If you smoke, quit. It’s not good for your health in general, and wotrse for you if you want to continue diving.
• Get in shape. Many of us sit behind a desk all day. Start an ­exercise regimen and get in shape. You don’t want to be sidelined from your favorite ­activity, do you?

About Lessons for Life

We're often asked if the Lessons for Life columns are based on real-life events. The answer is yes, they are. The names and locations have been removed or altered to protect identities, but these stories are meant to teach you who to handle a scuba diving emergency by learning from the mistakes other divers have made. Author Eric Douglas takes creative license on occasion for the story, but the events and, often, the communication between divers before the accident are entirely based on incident reports.