Traveling with Heart Disease

Heart disease, whether it be angina, myocardial infarction, the residual effects of rheumatic fever or whatever often raises a number of questions when it comes to travel. Especially air travel. And rightfully so. Heart attacks are the number one cause of death among Americans traveling abroad. They are also the number one cause of death on airliners.

The combination of stress and an increase in altitude with decrease in oxygen level is often the precipitating factor.

Stress can be reduced by getting a good check-up before one leaves, allowing adequate time for preparation and travel, getting adequate rest, and reducing the business or tourist activities to relaxed levels.

Altitude exposure at one's destination can be reduced by avoiding high-altitude destinations or arriving at the altitude gradually. The altitude exposure of commercial air travel cannot be avoided but is usually limited to the equivalent of 5000 to 8000 feet.

Someone who has recently had open heart surgery should probably not travel by air for at least two weeks and perhaps as much as six weeks. Also, they should not go to high altitudes for six months. Blood vessels that have been operated on may re-narrow up to 6-12 weeks after surgery. Also, expanding gases could cause great discomfort, and airsickness with vomiting could put excessive strain on healing tissues. A heart patient really should not be far from home until sure that he or she is stable. Unstable angina, congestive heart failure and an abnormal heart rhythm are all good reasons not to travel long distances or by air.

Usually, one's heart capacity can be tested quite well in advance of an anticipated trip. Treadmill stress tests, thallium scans, or programmed ventricular stimulation can all help to predict how much altitude and activity one can tolerate. The advisability of taking a particular trip may depend on the ability to reduce the work load, increase one's medications, or change to medications such as nitrates and Calcium channel blockers rather than Beta blockers.

Due to slower blood circulation and the fact that many heart patients are on diuretics, they are more prone to blood clots as well. In the dehydrating atmosphere and the diminished physical activity of a plane this becomes more of a problem. A brisk fluid intake, the room to stretch out and frequent movement about the plane are quite important in preventing this.

Pacemakers or implanted defibrillators are not affected by airport security measures and do not preclude international travel.