An inquest has concluded that 49-year-old scuba diver Patrick Doran, who died during a dive off the coast of County Donegal in north-western Ireland last year, suffered a heart attack unrelated to the dive itself.
The hearing was held yesterday (12 December) at Letterkenny Courthouse by coroner Dr Denis McCauley, and the proceedings reported by local press.
Doran, from Finisklin, Carrick-on-Shannon in County Leitrim, had been participating in the North West Dive Rally, a two-day event organised by Donegal Bay Sub Aqua Club. He and his dive-buddy were reported to be in difficulty at Teelin Pier at around noon on 22 June, 2024. The fatal incident was reported on Divernet.
Emergency responders, including Malin Head Coast Guard, the Garda, the National Ambulance Service and Rescue 118 helicopter crews, attended the scene. Despite CPR efforts, Doran was pronounced dead at around 1.20pm.
His buddy was medically assessed and later treated for symptoms consistent with decompression illness at Galway University Hospital.
‘Dive was irrelevant’
The coroner noted that Doran’s death had occurred against the backdrop of an unusually high number of diver fatalities off the Donegal coast, being one of three separate diving-related deaths within a six-week span.
A diving equipment expert found no specific faults with Doran’s gear, and his air-supply and buddy arrangements were judged to have been appropriate.
A post mortem examination of Doran showed no external injuries or diving-related trauma, but pathologists reported severe coronary artery disease (CAD) at an unusually advanced level for Doran’s age, concluding that he had died as the result of a heart attack.
In this case the dive itself had been irrelevant to Doran’s death, said the coroner, noting that he “could have passed away while walking Errigal Mountain or walking along the road”, He recorded a verdict of death by natural causes.
Checking for CAD
Statistically, cardiac events are a leading cause of diving fatalities, especially in divers over 40. CAD refers to narrowing or blockage of the coronary arteries caused by a build-up of atherosclerotic plaque.
When described as severe, this usually means that one or more major coronary vessels are significantly narrowed. This can substantially limit blood flow to the heart muscle, particularly during exertion or stress.
Diving can increase heart workload through immersion effects, as blood shifts from the extremities to the chest; coldwater exposure raising blood pressure and heart workload; and task-loading, especially in currents, surge or low visibility.
Many divers with CAD are physically active, display no warning symptoms and can pass basic fitness checks on land. Underwater exertion is not equivalent to walking, cycling or gym exercise, however, and factors such as breathing resistance, buoyancy control and thermal stress can push cardiac demand beyond what diseased coronary arteries can support.
If a heart attack occurs under water, early symptoms such as chest pain, breathlessness of fatigue can be misinterpreted as the effects of exertion or anxiety. Loss of consciousness can occur rapidly and, even with a competent buddy, rescue is time-critical but could be delayed by depth, ascent and surface logistics.
Regular cardiovascular screening becomes increasingly important with age, particularly for
male divers over 40, those with a family history of heart disease and those with high blood pressure, high cholesterol or diabetes.
