Can You Fly With Heart Problems?

Air travel can be uncomfortable — and for some of us, scary — even under the best of circumstances. It can be even more intimidating when you’re living with (or recovering from) heart disease.

But cardiologist Kenneth Mayuga, MD, says it doesn’t have to be that way. Dr. Mayuga shares what you should know — and what plans to make — before flying.

How does flying affect my heart?

Sitting on a plane 30,000 feet above the ground affects your body in many ways. What that means for your heart depends on the conditions you have and how they’re treated. Dr. Mayuga says it’s important to ask your healthcare provider about the risks of flying with your specific condition.

Air travel can affect your heart because of the:

• Lack of movement: Sitting still for long periods can slow your circulation and raise your risk for blood clots.
• Cabin pressure: Air pressure changes with elevation. That’s what causes popping ears and altitude sickness. During a flight, cabin pressure changes may stress your cardiovascular system.
• Reduced oxygen levels: A drop in air pressure may reduce your blood oxygen level. When that happens, your heart may beat faster to compensate, placing extra stress on your ticker and potentially causing symptoms like shortness of breath.
• Dry air: The air on airplanes is extremely dry. So, every time you breathe, you’re losing a little more water than you’re taking in. That’s a recipe for dehydration, which puts unnecessary strain on your heart. It’ll only get worse if you add caffeine or an alcoholic drink to the mix.
• Tension: Traveling may be fun, but it’s rarely easy. That added stress (and the flood of hormones that comes with it) could raise both your blood pressure and your heart rate.

Heart conditions affected by flying

If you’re recovering from a heart attack (myocardial infarction) or heart surgery, flying could impact your recovery by placing unnecessary stress on your heart. According to a 2017 review and research published by the British Cardiovascular Society, common heart conditions that can be impacted by air travel include:

• Angina
• Coronary artery disease
• Heart failure
• Congenital heart disease
• Valvular heart disease
• Cardiac arrhythmia
• Pulmonary arterial hypertension

Air travel can also affect you if you have a pacemaker, an implantable cardioverter-defibrillator (ICD) or a ventricular assist device (VAD). Also, speak to your provider before flying if you’ve had a procedure called a cardiac ablation.

Tips for flying if you have heart problems

When it comes to flying with a heart condition, preparation is everything. Here are some steps Dr. Mayuga recommends taking before you hit the runway.

1. Talk with your doctor

Check in with your healthcare provider if you’re planning a trip. It’s extra important that they give you a once-over if you have new or worsening symptoms. Also, follow up if you’re recovering from a recent heart attack, a stroke or heart surgery.

Your provider will help you determine if flying is safe and what, if any, precautions you may need to take. In some cases, you may be asked to do a stress test to ensure your heart is up for the trip. You may also be prescribed certain medications in advance of flying.

2. Pack your records

“It’s important that your heart-related medical information travels with you wherever you go,” Dr. Mayuga says. He recommends keeping the following information handy in case of emergencies:

• Your doctor’s contact information: If you’re hospitalized for any reason, having the contact information for all the members of your healthcare team at the ready can save precious time.
• A local provider’s information: Ask your cardiologist to recommend a provider or medical center close to your travel destination in case of problems.
• Copy of your ECG: If you have an irregular heartbeat, Dr. Mayuga recommends you ask your doctor for a copy of your electrocardiogram (ECG).
• Equipment details: If you’re traveling abroad, bring the contact information for your pacemaker or implanted cardiac defibrillator (ICD) manufacturer.
• Insurance details: Check that your health insurer will cover any care you receive while traveling. And consider purchasing medical evacuation insurance if your health insurance doesn’t provide it.

3. Manage your medications

If you need to take heart medication while traveling, make sure you have enough to last the whole trip. If possible, pack a few extra days’ worth in case of unexpected delays.

And remember: Always keep medications in your carry-on luggage in the original bottle. You don’t want to risk losing it or having it confiscated by security. And if you’re traveling to another country, check to see if you need to complete a medical import application.

4. Take precautions with metal detectors

Do you have a pacemaker or an implanted cardiac defibrillator (ICD)? If so, Dr. Mayuga recommends that you:

• DO alert the security staff that you have an implanted device.
• DON’T stand near the metal detector longer than necessary.
• DON’T lean against the metal detector.

If a handheld metal detector is needed, it shouldn’t be held over the pacemaker or ICD any longer than is absolutely necessary. If you’d prefer, you can also ask for a hand search (pat down) instead of the handheld metal detector.

6. Consider compression garments

If your provider told you that you’re at moderate risk for developing blood clots, compression socks or stockings are recommended. They can also be considered for use during longer flights. If you’re at high risk for developing blood clots, talk to your provider about their recommendations before flying.

7. Stay hydrated

Skip the salty snacks in favor of hydrating foods. And drink water — not alcohol — while you’re airborne. Alcoholic beverages will only worsen any dehydration that comes with flying. A nice bonus? Sticking with H₂O and low-sodium snacks can also help prevent jet lag.

8. Ask the flight crew for help if you need it

We get it: Nobody wants to be the reason the flight attendant’s looking for a doctor. And getting medical attention isn’t anybody’s idea of a vacation. But Dr. Mayuga stresses the importance of not ignoring symptoms when you have them. After all, your health is more important than your itinerary.

“Don’t be afraid to get checked for fear of spoiling your family vacation,” he urges. “Alert the crew if you have any chest pain, signs of a heart attack or other symptoms of heart disease while you’re in the air.”

And remember — the U.S. Federal Aviation Administration (FAA) requires passenger-carrying aircraft to have an automated external defibrillator on board. If you were to have an emergency on the plane, there are people trained to help you.

Final thoughts

Having heart disease doesn’t mean your adventuring days are over. It just means you have to do some extra planning. If you can’t seem to check your worries at the departure gate, reach out to your provider. They can help you lay the groundwork for a safe and healthy flight.