From the Guidelines
Patients with certain medical conditions, such as recent myocardial infarction, unstable angina, decompensated heart failure, uncontrolled arrhythmias, severe anemia, acute psychiatric conditions, seizures, recent stroke, recent surgery, and active communicable diseases like tuberculosis, should not fly due to the risks associated with air travel. According to the most recent guidelines, patients with heart failure should be assessed on a case-by-case basis, with those having NYHA class IV heart failure advised against traveling, and those with acute heart failure decompensation advised to wait at least 6 weeks after discharge and rehabilitation before traveling 1. Additionally, patients with infectious tuberculosis should not travel by commercial air transportation until they are rendered non-infectious, as indicated by three smear-negative sputum examinations on separate days or a negative culture result 1. Other conditions that may prohibit flying include severe chronic obstructive pulmonary disease, recent pneumothorax, deep vein thrombosis without anticoagulation, and sickle cell disease with recent crisis.
Some key considerations for patients with medical conditions who wish to fly include:
- Avoiding travel to locations with high levels of air pollution 1
- Using supplemental oxygen during air travel, if necessary 1
- Avoiding strenuous exercise and staying mobile during the flight 1
- Taking precautions to prevent deep vein thrombosis, such as staying hydrated and avoiding excessive alcohol consumption 1
- Carrying preventative and relieving inhalers in hand luggage, if applicable 1
It is essential for patients with medical conditions to consult their physician before flying to determine the best course of action and ensure their safety during air travel. The decision to fly should be made on a case-by-case basis, taking into account the individual's specific medical condition, the risks associated with air travel, and the potential benefits of traveling.
From the Research
Medical Conditions that Prohibit Flying
The following medical conditions may prohibit flying or require special precautions:
- Pulmonary conditions: Patients with pulmonary conditions who are unable to walk 50 m or whose usual oxygen requirements exceed 4 L per minute should be advised not to fly 2.
- Recent surgery: Trapped gases that expand at high altitude can cause problems for travelers with recent surgery 2.
- Ear, nose, and throat issues: Trapped gases that expand at high altitude can cause problems for travelers with ear, nose, and throat issues 2.
- Dental issues: Trapped gases that expand at high altitude can cause problems for travelers with dental issues 2.
- Cardiovascular disease: Air travel may pose medical complications for patients with cardiovascular disease 3.
- Chronic Obstructive Pulmonary Disease (COPD): COPD is a moderate risk factor for venous thromboembolism (VTE) 4.
- Venous thromboembolism (VTE): Travelers can minimize risk for deep venous thrombosis by adequately hydrating, avoiding alcohol, walking for 10 to 15 minutes every two hours of travel time, and performing seated isometric exercises 2.
Pre-Flight Precautions
Travelers with medical conditions should take the following precautions:
- Carry current medications in their original containers and a list of their medical conditions and allergies 2.
- Adjust timing of medications as needed based on time zone changes 2.
- Use the Hypoxia Altitude Simulation Test to determine specific in-flight oxygen requirements for patients who have pulmonary complications or for those for whom safe air travel remains in doubt 2.
- Wear compression stockings to prevent asymptomatic deep venous thrombosis and superficial venous thrombosis for flights five hours or longer in duration 2.