Can those suffering from heart failure travel by plane without running health risks?

My father suffers from heart failure due to dilated heart disease with reduced left ventricular systolic function, for which he undergoes periodic visits. He has a defibrillator. Thanks to the therapy he is following, he is fine and has no longer been hospitalized, but he is worried about the trip to Egypt that he would like to take to celebrate his 70th birthday. Can he safely fly? Is a pre-departure visit recommended?

He replies Massimo MapelliDepartment of Critical and Rehabilitative Cardiology, Monzino Cardiology Centre, Milan (GO TO THE FORUM)

The objective of therapy – pharmacological and otherwise – of heart failure is to allow people to live as normal a life as possible, compatible with the stage of the disease. In fact, if recognized and treated in time, many forms of imbalance are not such as to jeopardize the performance of many work or leisure activities., like taking a plane to go on holiday. We must strive to teach our patients “double-track” reasoning for which they must feel like they are heart patients on one hand (otherwise it would not be possible to explain the dozen pills a day they take on average and the need to undergo blood tests and diagnostic tests at least every six months) and on the other, non-heart patients.

Safe flights

L'aerobic physical exercise, for example, which is an integral part of therapy, is still considered by many doctors and patients to be a taboo for heart patients and is too often sacrificed on the basis of fears typical of defensive medicine. Instead controlled physical activity is like a “polypill”, with beneficial effects for the heart and mind. In this context, given its probable positive psychophysical repercussions, it is difficult to deny a patient the possibility of building his “health” in the broadest sense of the term, for example with a holiday. Modern flights are pressurized in such a way as to “simulate” an altitude of less than two thousand meters, considered largely safe in patients with clinically stable heart diseasei.e. without recent hospitalizations for heart failure, dependence on oxygen therapy, functional classes that are too advanced.

The advices

Even the presence of a defibrillator
which in these cases is implanted for primary prevention to interrupt any dangerous arrhythmias, does not in itself represent a contraindication to travel. Although the flight time to Egypt is relatively modest, common sense recommendations apply: take short, frequent walks to stretch out, drink an adequate amount of water avoiding dehydration, take the usual drug therapy. Your father will be able to discuss any more specific aspects with his cardiologist, but at the moment all I can do is wish him happy holidays.

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