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AIR TRAVEL RECOMMENDATIONS

We’re deep in the middle of the summer travel season, and with the latest fare wars, the skies are filled with folks looking to get away. But what, if any, are the risks of air travel for those with cardiovascular disease, such as a history of a heart attack or blood clot?

Though the risk of a heart attack during air travel is miniscule, it is best that those with a history of heart disease are prepared.

The FAA has mandated that every major commercial plane have at least one flight attendant on board carry an automatic defibrillator in the event a passenger suffers a cardiac arrest. According to FAA data in 1996, there were 433 episodes of chest pain and 141 heart attacks among 580 million passengers.

So, the risk is miniscule if you consider these numbers. But no one wants to be one of the few who suffer a heart attack in the air. The new recommendations on air travel risk in the latest Annals of Internal Medicine say in-flight factors including a lower cabin air pressure than what exists at sea level could reduce the amount of oxygen delivered to heart muscle and predispose one to a heart attack.

Those with uncontrolled chest pains or heart failure should not fly. Dr. Ram Jadonath a cardiologist at North Shore University Hospital in New York, says, “A patient who has undergone bypass surgery is probably the stablest patient to travel because their condition has really been corrected, but unless it’s urgent they really should wait 2-4 weeks.” This also applied to those who get a stent procedure, which struts a heart artery open at the site of a blockage. Low oxygen levels could trigger abnormal blood clotting at the stent site.

Perhaps one of the most significant concerns is the risk of blood clots in the legs, especially on long flights. So it’s a good idea to walk around before the flight, not sit down, and walk the aisles during the flight. Compression stockings are recommended for everyone 50 and older taking a flight longer than 8 hours in length.

And persons with pacemakers or implantable defibrillators should carry a card identifying the type of device as airport security will detect the devices. Security gates or handheld wands could potentially trigger an inadvertent shock if kept over the chest for too long a period. “What we advise all patients to do is to undergo a hand search. Patients can have a hand search but they could be standing right next to the security gate, which could be a problem,” states Dr. Jadonath.

Every patient should have a set of duplicate medications, one in their luggage and one in carry-on. Carry a list of your medical problems, medicines and dosages, and the phone number and website of the pacemaker or defibrillator company and contact.

As for pre-flight testing, there’s no evidence that a stress test is needed before air travel, but what does make sense and what is recommended is to see the physician who knows the patient’s history before flying. It’s recommended that at that physical a resting EKG be performed, the patient should get a copy and take it with him or her on the plane.

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