AIR TRAVEL IN HEART PATIENTS

  The British Cardiovascular Society has concluded in a new report that most people with cardiovascular disease who are not critically ill can safely fly on a commercial aircraft,. The main impact of air travel is the inhalation of air with reduced oxygen content in a pressurized environment, resulting in lower circulating oxygen levels in the blood, known as hypobaric hypoxia. Passengers already at high risk of angina, myocardial infarction, heart failure, or abnormal heart rhythms might be adversely affected by hypoxia, but the blood oxygen levels induced by flying “appear to have little or no adverse circulatory effects,” certainly not for short- and medium-haul flights.If  patients feel any discomfort or shortness of breath ,they should inform the flight attendant and should use oxygen mask located in the overhead compartment.Patients should also carry all the treatment records during travel.

For post-STEMI and NSTEMI(after a heart attack) , those at low risk are advised that they can fly three days after the event, and those at medium risk can fly after 10 days. However, those at high risk–ejection fraction <40%, signs and symptoms of heart failure, and those awaiting further investigation, revascularization, or device therapy–are advised to “defer travel” until their condition is stable.

After uncomplicated elective PCI(angioplasty), the guidelines state that patients can fly “after two days.” Likewise, patients with pacemakers implanted are advised that they can fly after two days .Those with ICDs should not fly after the ICD has delivered a shock until the condition is considered stable.

 

A long-haul flight doubles the risk of DVT(deep vein thrombosis),eventhough it is similar to that incurred during car, bus, or train travel for a similar period. And the absolute risk of DVT for a fit and healthy person is one in 6000 for a flight of more than four hours.

Even those at high risk–those who have already had a DVT, recent surgery lasting more than 30 minutes, known thrombophilia, or pregnancy, and those who are obese (BMI>30 kg/m²)–can still fly, provided they consume plenty of fluids, exclude caffeine and alcohol, wear compression stockings, and take a low-molecular-weight heparin injection during the flight. Aspirin is not recommended for prevention of deep vein thrombosis.