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Traveling With Heart Disease
Whether the destination is Thailand, China, or the Galapagos Islands, today’s travelers are flocking to more adventurous and exotic locales, often for longer periods of time. But how does travel affect your heart if you have heart disease? Depending on your health condition, there are several factors to consider when planning your next trip.
Before you leave, the first and most important step for all heart patients is to have a complete physical exam and get an accurate assessment of your current physical health. You should have a general idea of your current heart health before you leave. It will also help you have a better idea of what to expect when you are away from home.
Most people with stable heart disease that is monitored and controlled should have no problem traveling. However, travel is not recommended for people with conditions like uncontrolled angina, arrhythmia, heart failure, valvular heart problems, and high blood pressure. If you recently had a heart attack or heart surgery, you may need to postpone air travel until your doctor says it is safe. The time you need to wait depends on your condition and how you are recovering.
Different types of heart disease require different precautions. For example, people with heart failure traveling to high altitude destinations should keep track of their fluid and salt intake. Check with your doctor about precautions that are important for your condition.
Talk to your doctor about vaccinations. Flu exists worldwide. The US Centers for Disease Control and Prevention recommends adults have a yearly influenza vaccine to protect against contracting or possibly spreading the flu. Other vaccines will help prevent other illnesses while traveling. The need for Pneumococcal vaccines to prevent pneumonia will depend more on age and underlying health conditions. Keep in mind that some places you travel to may require that you have other vaccinations. Talk to your doctor about your travel plans and leave enough time for the vaccinations to take effect.
Finally, you should consider buying emergency medical evacuation insurance, particularly if you are traveling to a remote area.
After you have had your physical and notified your doctor of your travel plans, it is a good idea to document the following medical information and keep it with you at all times:
- Keep a list of all the drugs you are taking. Use generic names and indicate dosages, as drug formulations vary from country to country.
- Have a copy of some of your medical tests or records, such as an electrocardiogram.
- Have the name and contact information of your doctor.
- Include a brief letter from your doctor (on letterhead, signed and dated) that describes your condition, the need for any supplies or medications, and information on any implanted pacemakers or cardiac defibrillators you may have.
Pack and carry more than enough of each of your medicines to cover the length of your trip. Medication may be difficult to refill when you reach your destination. Check with your doctor or pharmacist to be sure that any medicines prescribed specifically for your trip (like malaria pills) do not interfere with your heart medicines. Keep all medicines in their original containers. Pack all of your medical information and medicines in your carry-on luggage to avoid losing them in misplaced luggage.
In the Air
Air travel in a pressurized cabin exerts certain influences on the body that are important for heart patients. Prepare by doing the following:
- Stay hydrated—Be sure to drink plenty of non-alcoholic fluids during your flight.
- Move around—Heart patients may be especially prone to blood clots due to diuretic use or slower blood circulation. Be sure to get up, stretch, and move around the cabin at least once every hour to avoid blood clots and the danger of deep vein thrombosis. Also, flex and relax your calf muscle often and do not wear constrictive clothing below the waist.
- Make advance arrangements for oxygen—If you will need supplemental oxygen during your flight, check for airline availability, policies, and cost well in advance, as some airlines do not provide oxygen. You may need to have a letter from your doctor or allow the airline staff to call your doctor.
- Pacemaker/defibrillator function—If you have an implanted device, ask your doctor if it is safe for you to go through the metal detector or for the security officer to screen you by other means.
Make sure you give yourself extra time at the airport to clear security. The Transportation Security Administration website has information about traveling with several medical conditions and what to expect at the security checkpoint.
In case of an emergency, many public places now have automatic external defibrillators and emergency medical kits on site.
On the Ground
When you arrive at your destination, be sure to pace yourself and avoid strenuous activities and unnecessary stress. Certain activities, like scuba diving, may be unsafe for your heart. Your doctor can give you advice about this.
You should also follow the Centers for Disease Control and Prevention's recommendations regarding safe drinking water and foods to eat or avoid in the locations that you will be traveling to.
Most of all, try to relax, and enjoy your trip!
International Association for Medical Assistance to Travelers
US Centers for Disease Control and Prevention
Heart and Stroke Foundation of Canada
Public Health Agency of Canada
2014 Recommended immunizations for adults: by age. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf. Accessed December 29, 2014.
Ask DAN: Heart issues and cardio medications. Scuba Diving website. Available at: http://www.scubadiving.com/training/2008/12/ask-dan-december-2008. Published December 15, 2008. Accessed December 29, 2014.
Automated external defibrillators. US Department of Labor website. Available at: http://www.osha.gov/SLTC/aed/index.html. Accessed December 29, 2014.
Bettes TN, McKenas DK. Medical advice for commercial air travelers. Am Fam Physician. 1999;60(3):801-808, 810.
Joy, M. Cardiovascular Disease and Air Travel. Heart. 2007;93(12):1507-1509.
Food and water safety. US Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/page/safe-food-water.htm. Updated April 21, 2013. Accessed December 29, 2014.
Travelers with disabilities and medical conditions. US Transportation Security Administration website. Available at: http://www.tsa.gov/traveler-information/travelers-disabilities-and-medical-conditions. Updated July 3, 2014. Accessed December 29, 2014.
Travel and heart disease. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Travel-and-Heart-Disease%5FUCM%5F447033%5FArticle.jsp. Updated November 11, 2014. Accessed December 29, 2014.
Traveling with heart disease. Med to Go website. Available at: http://www.medtogo.com/traveling-with-heart-disease.html. Accessed December 29, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014
- Update Date: 12/29/2014