New Air Travel Checklist for Heart Patients
People With Heart Disease Urged to Take Precautions Before Flying
July 19, 2004 -- People with heart disease should take
precautions and discuss travel plans with their doctor before stepping on an
airplane, according to a new report.
Researchers say the guidelines for safe air travel among people
with heart disease vary and are supported by little concrete information. But a
review of the available research shows people with heart disease can reduce
their risk of complications onboard by following a few simple steps.
Although the risk of angina, heart attack, and irregular
heartbeat or other major complications is small among people with stable heart
disease, researchers say heart-related problems account for a high percentage
of all in-flight medical emergencies. They also say that certain groups may be
at an increased risk for in-flight heart-related incidents. Those concerns
prompted the U.S. Federal Aviation Administration earlier this year to mandate
that an automated external defibrillator (AED) be placed onboard all
passenger-carrying aircraft with a maximum payload capacity of more than 7,500
Air Travel Poses Risks for People With Heart Disease
In the report, published in the July 20 issue of the Annals
of Internal Medicine, researchers reviewed the risk associated with air
travel for people with heart disease and presented a pretravel checklist for
Researchers say one of the biggest risks facing people with
heart disease when flying is venous thrombosis, or the formation of a blood
clot in the veins of the leg, pelvis, or arms. Sitting long hours, dehydration,
and the lower oxygen levels in a plane cabin can all predispose a person to
blood clots. Most data have shown that flights greater than eight hours pose
the greatest risks.
Air travel is also not recommended within less than two weeks
following a heart attack without complications. Flying is allowed after two
weeks in a stable person if they had a heart attack that had major complication
such as heart failure. If a person has undergone an angioplasty where a stent
(wire mesh) is placed in heart arteries, then a waiting period of one week is
recommended before flight travel. The period immediately following the stent
procedure carries a high risk of clot formation; air travel during this period
would increase the risk further.
Although no evidence shows that air travel will interfere with
pacemakers or implanted cardiac defibrillators (ICD), researchers say travelers
with these implanted devices should be rerouted for individual security
clearance with handheld metal detectors or hand searches. There have been no
reports of ICD dysfunction caused by handheld metal detector wands, but
researchers say the devices may pose a theoretical risk of delivering an
inadvertent shock to the wearer.
Patients with ICDs are advised to request a hand search if
possible. If a handheld device is used to clear a person through security
checkpoints, then the examiner should be advised to hold the handheld device
over the ICD for no more than a few seconds.
Researchers recommend the following pretravel checklist for
people with heart disease:
- Carry an ample supply of all medications, make sure they are labeled and
placed in carry-on baggage.
- Carry a copy of a normal electrocardiogram (ECG) if you have an irregular
heartbeat or have a pacemaker.
- Carry contact numbers and web site addresses for pacemaker and ICD
manufacturers and local representatives in the destination country if traveling
- Travelers over 50 years old or those under 50 with one or more risk factors
for deep venous thrombosis (such as obesity, large varicose veins, congestive
heart failure, pregnancy, recent major surgery, use of hormone replacement
therapy, or oral contraceptives) should wear below-the-knee compression
stockings (20 Hg-30 Hg) when traveling on a plane for more than eight hours or
- Confirm aisle seating if at risk for deep venous thrombosis this will allow
you to enter and exit your seat, walk around, and stretch your legs without
disrupting other passengers.
- Avoid alcoholic beverages onboard and remain well hydrated.
- Address any new symptoms with your doctor before traveling.
- Check the CDC's web site for up-to-date immunization and antimalarial
- Consider purchasing medical evacuation insurance if your health insurance
doesn't cover medical evacuation.