Traveling with Coronary Artery Disease
Matthew Rusk, M.D.
Coronary artery disease remains the most common cause of death for men and women over the age of 50. One study of deaths among U.S. travelers to Mexico found that circulatory disease was the second most common cause behind motor vehicle accidents 1. Despite these alarming facts, however, the risk of having a heart attack for travelers abroad is less than that of the population at home. New therapies have enabled patients with coronary disease to live active lives in which traveling is not a problem. Some common sense precautions for travelers with heart disease can ensure a safe trip.
Flying with Coronary Artery Disease
Patients who have had a heart attack (myocardial infarction) should not fly in airplanes for at least a month afterwards, and not without clearance from their physician. Patients with unstable angina or chest pain should not fly at all. As a general guide, patients with cardiac disease should be able to walk 100 yards and climb 12 steps before attempting a long flight.2
Discuss with your physician whether supplemental oxygen should be used during the flight.
If required, supplemental oxygen can usually be arranged by calling the airline ahead of time with instructions about what concentration of oxygen is needed and providing a physicians prescription.
Cardiac Medications and Travel
Some cardiac medications, such as digitalis (also known as Digoxin; common trade name is Lanoxin), do not have exact equivalents abroad. Travelers should bring extra medication on all trips abroad. As with all medications, cardiac medications should be stored in carry-on baggage. Nitroglycerin tablets, in particular, should also be kept out of extreme heat or sun in order to maintain their potency.
Travelers with a cardiac history should bring a copy of their most recent EKG—this is extremely important. In the event of an emergency, it is also very helpful to have a letter from the traveler's physician detailing the cardiac history. Results of recent cardiac catheterizations, stress tests, and echocardiograms should be included.
Pacemakers and Defibrillators
These are generally not affected by airline metal detectors. Before long trips these should be evaluated (often called "interrogated") by the traveler's cardiologist to ensure that they are functioning correctly and that the battery life is adequate.
1. Guptill KS, Hargarten SW, Baker TD: American travel deaths in Mexico-causes and preventative strategies. West J Med 154:169,1991
2. Kusumi RD. Medical aspects of air travel. Am Fam Physician 1981; 23 (6): 125-9