DR RICHARD BOGLE PHD FRCP FESC FACC DHMSA CONSULTANT CARDIOLOGIST
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Fitness to fly

Picture
Patients often ask if they are fit to go on holiday. Often this means taking a flight and so the question needs to be address by considering the hazards of airline transport and also about the availability of medical services if the patient becomes unwell whilst in their holiday destination.
At an altitude of 36,000 feet cabin air pressure is lower than that at sea level. Actually it is equivalent to being at 6,000 feet above sea level. The amount of oxygen in the air is lower and therefore less is taken up by the blood. Cabin air contains enough oxygen for healthy passengers but the blood oxygen level is reduced so people with  heart and lung disease may not tolerate this so well and supplemental oxygen may be necessary.
The bottom line is that if you can walk 50 metres or climb 1 flight of stairs without symptoms of shortness of breath and you have a chronic stable cardiac condition then you should be able to travel safely on an aeroplane, if not you may need supplemental oxygen during the flight.
Acute Coronary Syndromes

Low risk: (<65 years, first event, successfully treated with stent, EF>45%, no complications, no planned investigations or interventions): 3 days after the event,

Intermediate risk: (EF>40%, no heart failure symptoms, no inducible ischaemia or arrhythmia, no further investigation or intervention planned): 10 days

High risk: (EF<40%, signs and symptoms of heart failure): Defer air travel.
Heart Failure

Acute: This can be provoked by myocardial infarction, arrhythmia, infection or anaemia. Once the underlying causes is identified and treated most patient should be safe to fly after 6 weeks.

Chronic: People with stable heart failure without a recent change in symptoms or medication are likely to tolerate the low air pressure in the cabin. They should take precautions such as avoiding physical exertion at the airport and ensure a correct supply of medication. Patients with NYHA class III or IV symptoms should not fly without special assistance and should request in-flight oxygen.
Useful Links:

British Cardiac Society Fitness to Fly Guide
British Airway Air Travel Guide
British Airways information for passengers who require medical assistance
MEDIF Form British Airways
MEDIF Form Quantas
MEDIF Form Virgin Atlantic
IATA Medical Manual


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© Dr Richard Bogle 2020
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  • Home
  • Blog
  • NHS Practice
    • NHS Practice
    • St Helier Hospital
    • Epsom Cardiac Day Unit
    • St George's Hospital Radial Lounge
    • Echocardiography
  • Biography
    • Qualifications
    • About me >
      • Curriculum vitae
    • Appraisal and Revalidation
    • BCIS Angioplasty Audit
    • Publications
    • Recent abstracts
    • Research
    • Charitable activity
  • The Heart
    • Cardiac Investigations >
      • AliveCor ECG monitor
      • Guide to investigations for suspected angina
      • CT calcium scoring
      • Electrocardiogram (ECG)
      • Exercise treadmill test
      • Echocardiogram
      • Valve disease
      • Coronary Angiography
      • Pressure Wire Studies
      • Intra-vascular Ultrasound
    • Arrhythmias >
      • Atrial fibrillation >
        • Stroke Risk in AF
        • New Oral Anticoagulants
        • Presentations on AF
      • Atrial flutter
      • Pre-excitation syndromes
      • Ventricular ectopic beats
      • Ventricular arrhythmias
      • Pacemaker
      • DC Cardioversion
    • Cardiomyopathy
    • Coronary heart disease >
      • Cardiac syndrome X
      • Coronary Angioplasty
      • Coronary bypass surgery
    • Dizziness and blackouts
    • Fitness to fly
    • Fitness to drive
    • Heart Failure
    • Hypertension >
      • Patients guide to blood pressure medication
      • Home blood pressure monitors
      • Hypertension diet
      • Laragh's method
      • Renal sympathetic ablation for hypertension
      • Conn's Syndrome
    • Heart Screening >
      • Sports Cardiology
      • Cardiovascular Disease Risk
    • Medications >
      • Glyceryl trinitrate
    • Patient information leaflets
  • News and Links
  • Miscellany
    • History of Medicine
    • History of Coronary Angiography and Angioplasty
    • Stamps in Cardiology
    • A History of Medicine in 100 Objects
    • BSE Acceditation Course Introduction
    • BSE Acceditation Course Physics
    • BSE Acceditation Course Anatomy and Function
    • BSE Acceditation Course Mitral
    • BSE Acceditation Course Aortic
    • BSE Acceditation Course Congenital
    • BSE Acceditation Course Pericardium
    • RACPC Form
    • Cardiology Teaching St Helier Hospital