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Travel and heart disease - is it safe?

Want to travel and heart disease has you concerned? According to doctors, many people living with heart diseasecan travel safely - but there are some important things to consider. Here are some guidelines - but be sure to check with your own doctor.

Travel is permitted if:

  • you have had an uneventful stress test or negative angiogram (results that show good blood flow to the heart) within the past year. You should be fine as long as you remain on your prescribed medication.
  • 3 - 5 days have passed since your angiogram or angioplasty and you have medical clearance. Usually there are no restrictions after angioplasty if you are not experiencing chest pain.
  • your congestive heart failure or arrhythmias (irregular heartbeats) is satisfactorily controlled with medication.
  • four to six weeks have passed since you had an uncomplicated heart attack. A two-week wait is recommended after uncomplicated bypass surgery.

Travel restrictions may be recommended if:

  • you have recurring acute chest pain, heart failure, or rhythm disturbances that cause symptoms at rest or with minimal exertion
  • you have had a heart attack within the past 14 days or a heart attack causing shock or heart failure within the past 8 weeks.

If you have heart disease and diabetes, things can be more complicated - consult with your cardiologist.

Getting Ready to Go

If you haven't had a checkup recently, see your doctor. Ask if any tests are warranted to confirm that your cardiac disease is stable.

  • Get a written summary of your medical history (including a recent electrocardiogram) from your doctor so you can carry it with you.
  • Carry your doctor’s name and contact details, and your emergency contacts (usually next of kin).
  • Bring a list of all the drugs you are taking, including the dosage.
  • Carry adequate supplies of your prescribed medication (I alwaystake extra in case I am delayed returning home.)
  • Take your medications in their original packaging. This can help avoid issues with customs, but can also be of great help to a doctor if you need emergency assistance.
  • Keep your medication in your carry on luggage. This way if your luggage gets lost, you still have your medication.
Getting There

Air Travel

Flying generally doesn't pose significant risks to most people with heart disease. According to the British Heart Foundation, if you are fit enough to climb a flight of stairs without stopping, you are fit enough to fly. Another source suggests if you can walk briskly for 100 metres on flat ground without being breathless or in pain, you can fly.

Cardiac incidents occur only in 1 to 2 patients per million during air travel. But 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. Today, many commercial airplanes and public places, including airports, have automated defibrillators.

There is no evidence that flying interferes with pacemakers or implantable defibrillators but implanted pacemakers and cardiac defibrillators can trigger metal detectors at security, so you should have documentation proving you have an implanted device and ask to be hand checked.

One of the risks of flying travel and heart disease is the formation of blood clots. Encouraging your circulation and avoiding dehydration will give you the best protection against blood clots forming and therefore against heart attack and stroke:

  • Make sure you have plenty of legroom when you book - this may mean checking in early. These days you can check in online up to 24 hours in advance.
  • Stretch your legs and move your feet about every half hour. If you can, get up and move about the cabin.
  • Wear light-weight comfortable clothing, and shoes you can slip off easily.
  • Avoid alcohol before and during the flight as this makes you dehydrated.
  • Drink plenty of fluids, preferably water.

In some cases you may want to consider wearing compression stockings to avoid blood clots.

Some people with heart disease need to avoid flying because of the increased risk in a high-altitude, low-oxygen environment. Airplane cabins are pressurized to the equivalent of approximately 10,000 feet above sea level.

You should not fly if:

  • You had a heart attack (myocardial infarction) within the past two weeks.
  • You have had coronary artery stent placement within the past two weeks.
  • You have had coronary artery bypass surgery within the past three weeks (longer if you had pulmonary complications).
  • You have unstable angina, poorly controlled heart failure, or uncontrolled arrhythmias.
Other ways to get there

Travel by car, bus, boat or train remove the altitude issues and offer more options for periodic movement. In a train, you may be able to walk in the aisle to reduce the risk of blood clots. Of course when you are traveling by car you have the opportunity to stop as necessary to stretch and move about.

You might even want to consider smart heart vacations such as walking and cycling tours or relaxation retreats.

Medical and Travel Insurance

If you have heart disease you need insurance to protect you in the event of a cardiac event while you are away. With medical bills easily running into thousands of dollars, obtaining suitable travel insurance if you suffer from a pre-existing medical condition is an absolute must. Many policies exclude pre-existing conditions or impose terms that are unacceptable. Check with your insurer to confirm that any conditions you have are covered to your satisfaction. You may have to shop around for the right coverage.

Travel to developing countries
There are always risks associated with visiting developing countries. Assess the risk and consider the precautions listed above before you make your decision.

Depending on your condition you might be wise to avoid high-altitude destinations or plan to arrive at the altitude gradually to allow your body to adjust.

Finally, take a responsible approach to travel and heart disease - remember to check with your physician before setting off on your journey.

Bon voyage!

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