Can heart patient travel in flight? Guidelines for Flying with Heart Disease


Air Travel Is Generally Safe for Heart Patients, With Appropriate Precautions

Having heart disease doesn’t have to mean sidelining your travel dreams. Patients with heart disease can often continue to travel as they always have, but may need to take some extra precautions to fly safely.

Risks of Flying with a Heart Condition

In general, air travel does not pose great risks to most patients with heart disease. Cardiac “incidents” occur only in 1 to 2 patients per million during air travel.

However, some heart patients need to avoid flying, at least temporarily, because of the increased risk posed by being confined to a high-altitude (and therefore low-oxygen) compartment. (Airplane cabins are pressurized to the equivalent of approximately 10,000 feet above sea level.)

Although the risk is small for patients with a heart condition, heart problems comprise a large amount of in-flight medical emergencies and certain groups may be at greater risk. To prepare for these situations, the U.S. Federal Aviation Administration mandates that an automated external defibrillator (AED) is on board the majority of all passenger planes (those with a maximum payload capacity of more than 7,500 pounds).

One of the biggest risks for people with heart disease who are flying is developing a blood clot, or venous thrombosis, in the leg, pelvis or arm veins. Various factors, such as dehydration, lower oxygen levels in a plane cabin, and sitting for long periods of time can increase the risk of developing a blood clot while flying–especially for those with heart disease who are already at greater risk.

Guidelines for Flying With a Heart Condition

Researchers at Yale University have proposed guidelines for patients with cardiovascular diseases who wish to travel by air. To produce their guidelines, published in the July 20, 2004, issue of the Annals of Internal Medicine, the authors compiled data from numerous studies on air travel and heart disease.

Patients should not fly if:

  • they have had a heart attack (myocardial infarction) within the past two weeks
  • they have had coronary artery stent placement within the past two weeks
  • they have had coronary artery bypass surgery within the past three weeks (longer if they have had pulmonary complications)
  • they have unstable angina, poorly controlled heart failure, or uncontrolled arrhythmias

Notably, the authors found no evidence that air travel interferes with pacemakers or implantable defibrillators.

A preflight checklist for patients with heart disease:

  • talk to your doctor to see if any pre-flight testing may be warranted to assure that the cardiac disease is stable
  • carry adequate supplies of prescribed medicine
  • carry a copy of your medical history
  • carry phone numbers for your doctor(s) and family members
  • carry contact numbers and website addresses for pacemaker and ICD manufacturers and local representatives in the destination country if traveling abroad
  • during the flight, consider wearing compression stockings, pass on the alcohol, and drink plenty of fluids to avoid blood clots
  • confirm aisle seating, which will allow easy access to the aisle to walk around and stretch your legs
  • check the Center for Disease Control’s website for up-to-date immunization and antimalarial recommendations
  • consider purchasing medical evacuation insurance if your health insurance doesn’t cover that

– Reviewed by a board-certified physician.)
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