Advice for Travellers with Heart Disease

The British Cardiovascular Society has published advice on the risks associated with air travel for passengers with heart conditions. The guidelines are intended to be used as advice for such patients, rather than by airlines to decide whom they will permit to fly.

The “Best Treatments” summary of advice suggests the following people may fly without specialist treatment:

• People with mild angina, with no recent changes to either their condition or medication

• People with mild heart failure (described as causing breathlessness on mild to moderate exercise) with no changes to either condition or medication within six weeks

• People with occasional heart palpitations or irregular heartbeat, who are being treated, and whose condition doesn’t cause fainting

Where the angina or heart failure is more serious, or for people born with heart problems, extra assistance may be required at the airport as well as oxygen during the flight, to help make the journey easier and safer. Oxygen is available on most carriers, although it is sometimes subject to a charge and advance notice may be required. If symptoms are worsening, then travel should be delayed until the condition is once again stable.

The guidelines also give advice on the appropriate time interval between travel and either cardiac procedures or acute events. In addition, there are recommendations relating to the prophylaxis of deep vein thrombosis (DVT), as follows:

• Low risk (no history of DVT/VTE, no recent surgery or other risk factors) – non pharmacological measure such as keeping mobile, remain well-hydrated, avoid alcohol

• Moderate risk (e.g. previous history of DVT/VTE, recent surgery, pregnancy, elevated body mass) – non-pharmacological measures and compression hosiery

• High risk (recent surgery, previous DVT with additional risk factors) – advice as per moderate and consider low molecular weight heparin on the morning of the flight and the following day

Full details of the guidance can be obtained from the National electronic Library for Medicines here .