Is it safe for someone with congestive heart failure to fly?

Most patients with HF can travel when medically stable; patients with a ground-level oxygen saturation =90% or those in NYHA class III–IV might need an on-board medical oxygen supply. All medication and important documents should be stored in carry-on luggage.



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Dehydration due to cabin pressure at high altitude can affect your blood pressure, causing exacerbation of heart disease. 2 This is especially problematic if you have heart failure, CAD, or an arrhythmia.

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Unstable heart disease is associated with a higher risk of adverse events due to flying, and you may need to avoid flying, at least temporarily, until your condition is well controlled. People with pacemakers or implantable defibrillators can fly safely.

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Cardiac arrhythmia. Hypoxia and increased sympathetic activation may increase the risk of cardiac arrhythmias at high altitude2; however, the incidence of significant arrhythmias during air travel is rare.

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Does flying affect blood pressure? Yes it can. At high altitudes, even in a pressurised aircraft cabin, passengers are at risk of hypoxaemia (low oxygen concentration in the blood).

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Air travel increases the risk of developing blood clots in the veins of the legs, which can then enter the bloodstream and block an artery in the lungs, a condition called pulmonary embolism. In some cases, the opening can allow the blood clot to enter the arteries of the brain, causing a stroke.

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Low air pressure during air travel also decreases the amount of oxygen in the air. This effect is modest and generally not noticeable for healthy travelers. For patients with significant lung disease, a small decrease in available oxygen can cause significant symptoms, especially with exercise.

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Airlines “pressurize” the air in the cabin, but not to sea-level pressures, so there's still less oxygen getting to your body when you fly, which can make you feel drained or even short of breath. The potential dehydration factor and sitting for long periods of time doesn't help.

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