Researchers: Flying not as risky for heart patients as thought

PHILADELPHIA - Flying is not as risky for heart patients as doctors once thought, researchers say.

"The important take-home message is that for people with stable coronary disease, all the data points to air travel being safe," said Dr. Stephen Possick, a cardiologist at Yale University and an author of the paper published Tuesday in the Annals of Internal Medicine.

Commercial aircraft are not pressurized to a ground equivalent and the oxygen level is lower at high altitudes. Those factors have long prompted fears that flying could interfere with circulation and endanger passengers with heart or blood vessel problems.

The researchers reviewed dozens of recent studies of people with different kinds of cardiovascular disease, patients with pacemakers and those who had recently undergone heart procedures such as stent implants and angioplasty.

For those whose heart disease was under control and who had no post-surgery troubles or major bouts with chest pain or other troubling symptoms, the risk is low that air travel will create problems, Possick said.

The researchers concluded that people should not travel if they have had a heart attack, an angioplasty or a heart stent implant in the preceding two weeks, or if they have had a coronary artery bypass within the previous three weeks.

People also should not fly if they have an unstable angina, which is chest pain caused by lack of blood flow to the heart; an abnormal heartbeat that is not well controlled by medication; or heart failure that does not respond well to medication.

The report said it is also a good idea for many heart patients to wear below-the-knee compression stockings and get up and walk around during long plane rides to prevent deep vein thrombosis, or blood clots that typically form in the legs and can be painful and even fatal. The authors said there is no hard evidence that taking aspirin during a flight does anything to prevent such clots, so recommendation was made either way.

Dr. Gerald Fletcher, a spokesman for the American Heart Association, said the guidelines provide a good rule of thumb.

"Flying is a part of life, and in general it's not problematic," he said. "Heart disease is so common, and there's no need to frighten people into thinking they can't travel."

While none of the findings are new - the Aerospace Medical Association published similar guidelines in 2002 - Possick said the review puts together recent research in a way that family doctors can use and share with their patients.