About 2 billion people travel by air each year. As our population ages, more and more of them have heart disease. Should they worry? Are there any risks? What precautions should they take?
Although there are very few good studies that have looked at heart disease and travel, most people apparently do not have problems. There are some at risk and there are certain precautions it might be wise to take before anyone travels with heart disease.
The Air Transport Association has reported that out of 580 million passengers who flew in 1996, there were 433 episodes of chest pain (angina) and 141 heart attacks. During a period of 12 months spanning 1996 and 1997, 15 deaths were reported by MedAire, a company that provides medical support if there are in flight problems.
As of April this year, the Federal Aviation Administration (FAA) requires most commercial flights to carry automatic defibrillators. Some worry that the increased stress of flying, especially after 9/11, increases the risk of heart problems. Although there is some danger to people with CAD at high altitudes, scientists theorize that because flying is sedentary, there is low risk for an in flight heart attack.
Only been one study has looked at patients who flew after a heart attack. The study looked at 38 patients who traveled two to three weeks after a heart attack. No problems were encountered. But, since the study is so small, cardiologists do not want to make too many generalizations about it.
If a patient has irregular heart beats, there are more risks with higher altitude. When a person has an implanted defibrillator, they may be at greater risk but again, it seems to be very low. The Triggers of Arrhythmia Study currently underway should shed light on these dangers.
When is it safe to travel after a heart attack? The American College of Cardiology and the American Heart Association and other medical groups recommend waiting 2 to 3 weeks after an uncomplicated heart attack and 6 weeks after a more serious one. This is also the recommendation after angioplasty because there is a greater risk of clots or trouble with a stent during the first week after the procedure. While there are no guidelines, it is suggested that patients wait at least three weeks after coronary bypass surgery.
What precautions should you take before you travel? Carry all medications with you. Be sure they are professionally labeled and carry a separate list with both the regular names and their generic names. Warn security personnel if you carry lancets or syringes. A copy of a recent resting electrocardiogram and a summary of your recent medical problems along with telephone numbers is a must.
Patients with pace makers should carry a card identifying the pacemaker. They should request a hand search since the wands may disrupt the pacemaker. If security insists on using the handheld device, they should be asked to limit its use to a few seconds and wait 30 seconds before a second weep.
In flight oxygen is not necessary for most CAD patients. If you require supplemental oxygen, you must use the oxygen provide by the carrier. You have to notify the airline at least 48 hours before your flight and provide a letter of clearance from your physician. There is an extra charge for the oxygen of between $50 and $150 per leg. Not all airports provide oxygen for stopovers.
Because heart patients are at greater risk for embolisms or clots, it is recommended that they use below the knee compression stockings, get aisles seats, and walk during the flight. Some doctors tell their patient to start taking or increase their dose of aspirin prior to the flight.
Finally, check your health insurance. If it does not cover overseas travel, you may want to buy travel health insurance. Another type of insurance to consider pays for transportation home if there is an emergency.
While it appears that travel is OK for persons with heart disease, it does require a lot more planning.