Traveling with Heart Disease – what you should know.
Patients with known heart disease should not be limited from enjoying travel. Knowing your limits and what to do when symptoms present can be life-saving. If you have known atherosclerosis (clogging of the arteries of the heart with cholesterol and plaques) you need to make sure that the plumbing is open before you undergo any physical stress such as that which you may encounter on a vacation.
If you have had an uneventful stress test or negative angiogram (results that show good blood flow to the heart) within the past year you can feel secure as long as you remain on any prescribed medication. If within the last 6 months you have had a successful procedure to restore blood flow to the heart (bypass surgery, stent placement(s), or angioplasty) you should feel comfortable traveling. As with any major surgery, bypass surgery patients should wait 2 weeks before any major travel. Most of these procedures last much longer (5-15 years) if you stay on your medication and don’t smoke, but as a precaution patients should be evaluated for early complications or failures 6 months after their procedure. If you have congestive heart failure or a history or arrhythmias (irregular heart beats) you can travel as long as your condition is controlled with medication.
Diabetics with heart disease can be a little more complicated and rather than discussing all the physiologic issues, we recommend that all diabetics consult with a cardiologist to determine their fitness to travel. For others, if you have any concerns see your physician prior to your trip. We recommend that all persons with a history of heart disease or those that have significant risk factors for heart disease travel with the following information:
1) Recent laboratory studies
2) Recent history and physical exam results
3) Recent EKG, echocardiogram and treadmill stress test if available
4) Copies of any invasive studies or procedures such as angiogram, stent(s) placements or bypass surgery.
5) List of your current medications
6) Telephone number of your primary care physician and cardiologist.
Anyone with the following major risk factors should also carry the above information:
1) Smoking history (greater than 10 years)
2) High blood pressure
3) Age greater than 65
4) High cholesterol
5) Morbid Obesity
If you do travel, knowing what symptoms should cause concern may be helpful. The following is a list of symptoms and signs that should prompt you to seek medical attention:
1) Irregular pulse or one that is uncharacteristically very fast (greater that 100 beats per minute) or very slow (lower than 50 beats per minute)
2) Shortness of breath
3) Light headedness
4) Undue and uncharacteristic fatigue
5) New-onset swelling of the lower extremities.
Classic symptoms of a heart attack would be chest pain that is described as a heaviness or a pressure sensation in your chest. The pain can radiate to your neck or jaw and even down the left arm. Sweating, nausea and/or light-headedness are often present.
Not so classic may include a “stomach ache” that does not respond to anti-acids but goes away by sitting down and resting.
Diabetics with heart disease sometimes feel no chest pain but only dizziness, fatigue and/or shortness of breath.