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IT’S OK to fly even if you have serious heart problems, according to this week’s advice from the British Cardiovascular Society.

Its guidelines are much more upbeat than previous reports on air travel and heart disease, which warned of heart attacks and lung failure from deep-vein thrombosis – when blood clots form, blocking veins and arteries.

“The cabin environment doesn’t pose a significant risk to heart health,” says lead author David Smith at the Royal Devon and Exeter NHS Foundation Trust in the UK. The key for those with a pre-existing heart condition, Smith says, is to make sure that it is fully diagnosed and under control when you fly. “It’s down to how stable your condition is,” he says.

People who have recently had heart attacks, for example, should make sure they take their medication, avoid caffeine and alcohol, and walk regularly during the flight. The advice is published in the journal Heart, and lists in-flight precautions for a range of heart conditions.

The report does acknowledge that the risk of clots forming in the lungs is doubled in healthy people during flights of 4 hours or more. However, this is because people are forced to sit still for hours, and the risk applies to other forms of long-haul travel, such as car or train, Smith says.

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What does the new report say?

These groups of people can fly without any special treatment:

* People with mild angina (chest pain) that only happens during moderate exercise, whose condition and medicine has not changed recently
* People with mild heart failure, which causes breathlessness on mild to moderate exercise, whose condition and medicine has not changed within six weeks
* People with occasional heart palpitations or irregular heartbeat, whose condition doesn’t cause fainting and who are being treated.

People with more serious angina and heart failure, or people born with heart problems, are advised to consider whether they need extra assistance at the airport, and oxygen during their flights. If they are getting symptoms that indicate their condition might get suddenly worse, they are advised to wait until their condition is stable before travelling by air.

If someone has had a heart attack, they should be able to fly after three days if they’re under 65, have had the blocked artery successfully opened, and their heart is pumping normally. Older people who are not breathless and don’t have chest pain should wait 10 days. People whose heart is not pumping properly, who are still breathless, or who need further tests or treatment, should wait until their condition is stable.

People who’ve had a pacemaker or defibrillator fitted, or who have had their arteries widened by a balloon or stent, can fly after two days, providing there are no complications from their operation. People who’ve had a coronary artery bypass graft should wait 10 days, assuming there are no complications.

The guidelines say people are at low risk of a DVT if they have never had one before, have not had an operation in the past eight weeks, and don’t have any other risk factors. For these people, the guidelines recommend keeping mobile, drinking plenty of non-alcoholic drinks, not smoking, and avoiding caffeine or drugs that make you drowsy.

People at moderate risk include those who’ve had a DVT before, who are pregnant, who’ve had surgery four to eight weeks previously, who are known to have blood that clots easily, or who are very overweight (obese). For these people, the guidelines recommend wearing compression stockings as well as taking the steps above.

People at high risk include those with a previous DVT who also have another risk factor, such as having cancer, or who’ve had surgery during the past four weeks. These people can still fly, but they may need injections of an anti-clotting drug (called enoxaparin) before and after the flight. They should also wear stockings and take the other safety precautions.

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