Heart Disease and Travel
With some exceptions, having heart disease is not a reason to refrain from travelling. Indeed the disease itself may be the reason for travel. Simple precautions will reduce the chances of trouble.
Travel is tiring. The distances you might have to walk in airports, sometimes up & down stairs, or while sight-seeing & shopping can add up to many, many kilometres. Bags get heavier the longer you carry them. You may have difficulty in getting enough sleep, & jet lag can add to the stress of travel so careful itinerary planning is an essential part of reducing the risk. Do not be ashamed to ask for help. It can be useful to arrange for wheelchair assistance. Airlines much prefer to know in advance that you may need help rather than dealing with an emergency. Airlines also need to know if oxygen may be required as special arrangements need to be made especially on smaller aircraft.
Travelling by air is a little like exerting yourself while sitting doing nothing because of the reduced oxygen supply. Planes are pressurised to the approximate equivalent altitude of 8000 feet at which level a healthy person will be comfortable on mild exertion. If at home you are breathless at rest or with very little effort you probably are not fit to fly or will need oxygen on the trip. An airline rule of thumb is that you should be able to walk 100 metres carrying a suitcase at a reasonable pace with no discomfort. This is a minimum requirement but you should still talk to your doctor about your fitness to fly if you are on treatment for cardiac failure or if your condition is not well controlled
In general a person with one of the following conditions should not travel:
· within 10 days of an uncomplicated heart attack
· within 14 days of an uncomplicated stroke
· within 14 days of an acute deep vein thrombosis
· uncontrolled & unstable angina pectoris
· uncontrolled significant heartbeat irregularity
· uncontrolled congestive heart failure
· uncontrolled high blood pressure
Keep medications in the original pharmacy dispensed pack & have a separate list of all medication taken giving the trade & generic names as the trade names vary between countries.
Pacemakers are not affected by security screening apparatus. Because it may not be possible to access telephonic checking of pacemakers the traveller should keep details of the type & make of pacemaker, & a recent electrocardiograph tracing.
Chest pain on exertion - angina pectoris - if controlled by medication is no bar to travelling but it is essential that you keep "rescue' medication such as a sublingual nitrate spray or tablet in pocket or handbag.
If you are on an anticoagulant such as warfarin have an INR test done shortly before travel & another as soon as reasonably convenient at the final travel destination if you intend to stay there for more than a few weeks. Bear in mind that in some areas in underdeveloped countries it may not be possible to get a test done.
A sluggish circulation - especially in someone overweight & even more in a smoker - predisposes to clotting of the veins in the calf. This is of particular concern when flying. Avoid tight fitting clothing, exercise the feet & ankles while sitting, & get up & take a small walk now & then. Avoid alcohol or take it with plenty of water or soft drink.