The number of air travelers with cardiac disease will continue to increase. Advances in pacemaker, AICD and revascularization will allow many who could not travel only a few decades ago to do so with relative ease. This growing population will face a variety of hazards related to air travel, including in-flight ischemia, arrythmia, and venous thromboembolic events. Although there is a dearth of research specifically examining the air traveler with cardiac disease, we have attempted to provide a set of guidelines based on available evidence and basic pathophysiology. These guidelines should not substitute for cardiologic consultation when warranted.
Future research is needed to further assess the risk of air travel after MI in the age of more complete revascularization and more aggressive antiplatelet therapy. None of the trials cited discuss the use of glycoprotein IIb/IIIa inhibitors, clopidogrel, or drug-coated stents. AMA guidelines on this topic may require revision based on these advances. The current generation of pacemakers and ICDs would allow easy access to data regarding in-flight arrhythmia and might help to further elucidate the impact of altitude on the occurrence of ventricular and atrial arrhythmias. The increasing availability of AEDs will provide further data regarding the incidence of cardiac arrest as a cause of in-flight medical events and in-flight death.
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We are greatly indebted to Barry Zaret, MD and William Batsford, MD for their input and review of this manuscript, as well as to Carolyn Karbowski for her assistance in readying it for publication.Reprint Address
Reprint requests: Michèle Barry, MD, FACP, Professor of Medicine and Public Health, Yale School of Medicine, 333 Cedar Street, PO Box 208025, New Haven, CT 06520-8025.
J Travel Med. 2004;11(4) © 2004 International Society of Travel Medicine
Cite this: Air Travel and Cardiovascular Disease - Medscape - Aug 01, 2004.