Introduction
Do you suffer from Angina? Are you in a dilemma whether to take a flight or not? Do you want to know if it safe to do so? Don't stress it! We have all the answers for you.
Angina
Angina is a feeling of constriction in the chest, neck, shoulders and arms caused by a lack of oxygenated blood in the heart. In patients with ischemic heart disease, also known as coronary heart disease, this is a common manifestation. There are a wide range of symptoms associated with angina such as heaviness and constrictive feeling in the chest, pain in the arms, shoulder, and neck, shortness of breath, cold sweat, nausea, vomiting, and sometimes syncope.
The major causes of angina are atherosclerosis, spasms of the coronary arteries due to physiological triggers, platelet aggregation, decrease in blood sugar levels, and increased metabolic need of the body as a result of hyperthyroidism.
Types of Angina
The American Heart Association classifies angina into 4 major groups: stable, unstable, microvascular, and variant or prinzmetal angina.
Stable angina occurs due to increased exertion and usually lasts between 5 and 10 minutes. It will subside after resting and/or taking medicine. Angina can be triggered by extreme temperatures (hot or cold), overeating, emotional or physiological stress, and smoking.
In contrast to stable angina, unstable angina happens unexpectedly, occurs in response to rest and mild exertion, and does not improve with rest or medication. If it worsens, it could lead to a heart attack.
Microvascular angina occurs due to spasms in minute blood vessels of the heart. The pain stays longer than any other type of angina and is associated with fatigue and shortness of breath.
Variant angina, also known as prinzmetal angina, is a rare type of heart condition which occurs due to spasms of the coronary artery due to smoking, emotional stress, exposure to extreme temperatures. It occurs at midnight or early morning and is more severe than other forms of angina and may last longer, but can be relieved by taking medicines such as nitrates and calcium antagonists.
Travelling With Angina
Can you fly with Angina?
Flights typically travel at 25,000-35,000 ft in height with an air pressure of 4,000-5,000 ft in the cabin. A healthy person will not be affected by these conditions, but a person with cardiovascular disease may experience distress and hypoxia. The altitude could exacerbate underlying heart conditions by decreasing oxygen flow to the heart and causing blood vessels to spasm.
UK civil aviation authorities state that patients with stable angina can travel by plane without any problems; however, there are a few reservations for patients with unstable angina. Similarly, the British Cardiovascular Society recommends that patients with classes I and II may fly without any restrictions, while patients with severe unstable angina must travel with in-flight oxygen and their medications. Patients suffering from class IV angina are advised to delay air travel; however, if not, medical escorts should be used.
Physical assessments before flying from your doctor is advised for patients with angina. It is also important to inform the crew members and airlines about these needs or conditions.
Travelling safely
Invest in travel insurance
It is always advisable to take out travel insurance while planning an air journey. Travel insurance is the best way to take off the financial stress while travelling. This makes access to medical facilities in any untowards situation convenient and hassle free. It covers all the aspects of travel, including getting you home safely in case of a mishap. There are numerous plans available but it is always advisable to do thorough research about the insurance: what they cover, comparison of the cost and premiums, and the compensation method. Good and appropriate insurance could prove to be a valuable asset in case of emergencies.
Don't let stress overwhelm you by planning ahead
The passengers must plan their travel ahead to avoid any stress and arrive at the airport earlier to avoid last-minute hassles. It is always advisable to make sure the airline is aware of the condition and has necessary in-flight oxygen and equipment ready in case of any emergency. Patients must also carry emergency medicines such as GTN (Glyceryl Trinitrate) spray in their carry-on luggage and ensure that it is easily accessible. A note by the GP stating the condition, medications, doses, and steps to be taken in case of emergency could come in handy in any unforeseen circumstances.
Avoid carrying heavy objects/take advantage of airport assistance
Always make sure that the patients do not lift any heavy luggage/objects before the flight, as it is one of the most common triggers for angina.
Most airlines and airports provide wheelchairs, porters, and other assistance for travellers with health conditions.
Contact your airlines beforehand and explain your situation, and It is always advisable to take advantage of these services to have a stress-free experience while travelling.
Summary
Now that we have the required information about Angina and its effects on patients with Angina, dos and don'ts of air travel, we can answer the question CAN YOU FLY WITH ANGINA, and the answer to the question is YES!! You can fly with angina!!
The UK civil aviation and the British Heart foundation both have concluded that it is safe to fly with angina. Of course, one must take due measures and precautions before flying, i.e., Making sure you plan everything ahead of time, contacting the airlines and talking to your GP, keeping your medications handy, and most importantly No stressing, heavy weight lifting and seeking help if necessary. Bon Voyage!
References:
- Yasue H, Kugiyama K. Coronary Spasm: Clinical Features and Pathogenesis. Internal Medicine. 1997; 36(11):760–5. https://pubmed.ncbi.nlm.nih.gov/9392345/
- Pizzorno J, Murray M, Joiner-Bey H. Angina pectoris. Elsevier. 2016; 53–9.
- Beighton PH, Richards PR. Cardiovascular disease in air travellers. Br Heart J. 1968; 30(3):367–72.
- Levine BD. Going High with Heart Disease: The Effect of High Altitude Exposure in Older Individuals and Patients with Coronary Artery Disease. High Altitude Medicine & Biology [Internet]. 2015 [cited 2022 Apr 7]; 16(2):89–96. Available from: http://www.liebertpub.com/doi/10.1089/ham.2015.0043.
- Home. BCS [Internet]. 2020 [cited 2022 Apr 7]. Available from: https://www.britishcardiovascularsociety.org/home.