Can people with heart disease fly?

August 5, 2010 by  
Filed under HEART AND STROKE

It is holiday or vacation time in many parts of the world and many people are travelling by car, boat, train or plane, with the mode of transport mainly determined by distance. Summer school break is definitely the peak season for flying as people have more time for longer and farther trips. But how safe is air travel for those who have heart problems and other chronic conditions?

The British Cardiovascular Society recently issued a guidance on the safety of travelling on a commercial aircraft that will help both primary health care clinicians and their patients.

But first of all, how does air travel affect our health? The authors explain:

“…the main impact of air travel is the inhalation of air with reduced oxygen content in a pressurized environment, resulting in lower circulating oxygen levels in the blood, known as hypobaric hypoxia. Passengers already at high risk of angina, MI, heart failure, or abnormal heart rhythms might be adversely affected by hypoxia.”

Recent studies have shown however that the blood oxygen levels have little or no adverse effects on the circulatory system, certainly not in short-haul flights.

Based o these new findings, here is what the new guidelines has to say:

Patients after heart surgery

What are the travelling restrictions for those who had just a heart surgery? The guidance states it depends on the type of procedure and the risk profile of the patient.

“For post-STEMI and NSTEMI, those at low risk are advised that they can fly three days after their event and those at medium risk can fly after 10 days.”

Those with high-risk profiles should wait a little longer for stabilization. At any rate, the decision to fly should be discussed with the doctor.

Heart patients with pacemakers and other implants

People are wondering how flying can affect their implantable cardioverter defibrillators (ICDs), pacemakers and stents. The guidance states that  in most cases, flying is safe for people wearing these implants.

“After uncomplicated elective PCI, the guidelines state that patients can fly “after two days.” Likewise, patients with pacemakers implanted are advised they can fly after two days, unless they have suffered pneumothorax, in which case they should wait until two weeks after it has fully healed. The same advice applies to those with ICDs, with the added recommendation that they should not fly after the ICD has delivered a shock until the condition is considered stable.applies to those with ICDs, with the added recommendation that they should not fly after the ICD has delivered a shock until the condition is considered stable.

Deep vein thrombosis (DVT) and venous thromboembolism (VTE)

Many studies have shown that the risk for DVT and VTE increase when flying for long periods of time such as during a long-haul flight. However, the same increased risk applies when travelling by car, bus, or train. The absolute risk for DVT among healthy individuals is 1 in 6000 for a long-haul flight (e.g. more than 4 hours).

“Even those at high risk—those who have already had a DVT, recent surgery lasting more than 30 minutes, or known thrombophilia or are pregnant or obese (BMI>30 kg/m2)—can still fly, provided they consume plenty of fluids, exclude caffeine and alcohol, wear compression stockings, and take a low-molecular-weight heparin.[as blood thinner]..”

Warning: Aspirin as a blood thinner during flying is not recommended!

Transparency site on medical radiation devices launched

April 21, 2010 by  
Filed under CANCER

Due to the recent events in connection with medical radiation-associated health problems, regulators in the US are taking steps to resolve these issues. The US FDA has recently launched its Center for Devices and Radiological Health (CDRH) Transparency Web site which provides “information about medical device and radiation-emitting product regulatory processes and decisions, and summaries of data that provide the rationale for agency actions.”

To back track a bit, several studies have investigated radiation exposure of patients when undergoing diagnostic procedures that involved radiation-emitting devices, including the widely used computer tomography (CT) scans. These studies found that radiation levels used by these machines vary considerably and are not regulated. Previous research has shown strong links between radiation and cancer.

In addition, several cases of radiation overdose, some of them with very serious consequences, have been reported.

The new site covers the following:

Information on clearance reviews and premarket approvals will be incorporated in the near future.

We as patienst and consumers hope that this initiative will improve the safety levels of medical radiation.

Photo credit: stock.xchng

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.