Matthew Rusk, M.D.
With careful planning, patients with Congestive Heart Failure (CHF) can travel safely.
One of the most important problems for travelers with congestive heart failure is altitude. In general, patients whose symptoms are poorly controlled should not travel on airplanes. All patients who have congestive heart failure should first consult their doctors before traveling but as a general rule should be able to walk 100 yards and climb 12 steps if they are to attempt a long plane flight.1
Altitudes of even 5,000 feet, which may be commonly seen in many parts of the western United States, may worsen symptoms of congestive heart failure. Heart failure patients may also be particularly susceptible to the symptoms of altitude sickness, which may include shortness of breath and profound fatigue. Symptoms of worsening congestive heart failure, such as shortness of breath and a rapid heart beat, are also commonly seen in altitude sickness. In general, patients with congestive heart failure should avoid traveling to locations at high altitudes.
Medications and Medical History
Travelers with congestive heart failure should carry a list of their medications using the generic name for each drug. Remember that Digitalis (also known as Digoxin, often sold by the trade name Lanoxin) do not have exactly equivalents overseas. It is also important to bring extra medications and store them in carry on luggage for the flight. A baseline electrocardiogram should be carried as well as the name and address of the patient’s doctor. A brief letter from the patient’s physician describing the traveler’s medical problems will be very helpful to the evaluating physician.
Pacemakers and Defibrillators
Cardiac pacemakers and implantable defibrillators are safe to fly with and will not be affected by airline metal detectors. Those travelers with pacemakers should carry a copy of their electrocardiogram both in the off (generally after a magnet has been applied) and the on position.
Travelers taking diuretics should be particularly careful about their salt intake. It will often be difficult to determine the salt content of foods in other countries. Diuretics may also make patients with congestive heart failure susceptible to dehydration. They should rest frequently and avoid overexertion particularly in hot climates. Patients on blood thinners like Coumadin need to watch their intake of green leafy vegetables and other foods that contain Vitamin K, as these can affect the effectiveness of the medication. The goal is to consumer about the same amount of Vitamin K as you do at home.
1. Kusumi RK. Medical aspects of air travel. Am Fam Physician 1981; 23 (6): 125-9