Should you fly with a weak heart?

National Institute for Health and Care Excellence (NICE) guidance says that most people with heart failure can travel by plane. However, during the flight, legs and ankles tend to swell and breathing may become more difficult for people with severe heart failure.



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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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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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Before flying, those who have heart disease or have undergone a cardiac procedure should discuss their plans with a doctor. Some of the risk factors that might affect that decision include an unstable heart condition, long flights, flying to a high-elevation destination, and personal risk for blood clots.

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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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Beta-blockers are typically used to provide short-term relief of physical symptoms caused by anxiety. Most people who take beta-blockers for anxiety take the medication as needed before an anxiety-inducing event, such as a plane flight, public speaking engagement, or medical procedure.

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Airplane Travel and Blood Oxygen Saturation Local hypoxia causes vasodilation (decrease in blood pressure) and increased capillary permeability, as well as increased ventilatory effort and heart rate. One study found a passenger had a blood oxygen saturation of 94% at ground level and 85% at altitude.

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Myocarditis causes a weakening of the heart, which makes it unable to pump enough blood to the rest of the body and increases the probability of blood clots occurring in the heart, leading to a stroke or a heart attack. The act of flying and the conditions inside a commercial plane cabin further exacerbate these risks.

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If your blood pressure is higher than 120 over 80, seek medical advice before you travel.

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Flying produces an inconceivable amount of C02 emissions and air pollution. For those that don't know, CO2 (carbon dioxide) is one of the key greenhouse gases that contribute to global warming – flying produces a whole lot of it.

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