Long flights and extended sitting combined with low air pressure can put extra strain on the heart and lungs. For people with heart conditions, it’s essential to be cautious when traveling by plane. Experts advise that with the proper preparations, those with heart conditions can still enjoy air travel.

Dr. Liu Zhongping, a cardiologist in Taiwan, shared a story on the NTD “Health 1+1” program about a couple who argued at his clinic. The husband had recently suffered a heart attack and had been in intensive care. About a month prior, he had had heart valve surgery and had been stable since. He wanted to return to his home country to recuperate, but his Taiwanese wife strongly opposed the idea, feeling that flying so soon after heart surgery was risky. After assessing his condition, Liu believed the man could travel safely by air as long as he took his regular medications and had emergency medication on hand.

“Our view as doctors is that if your heart condition is stable, we encourage people to travel and take flights,“ Liu said. ”Don’t let heart disease limit your enjoyment of life.”

Avoid Flying in These 2 Situations

Flying can pose extra challenges for people with heart conditions. Air pressure drops by more than 60 percent at high altitudes compared with sea level. While cabins are pressurized, oxygen levels are still about 30 percent lower than on the ground. Healthy people can usually adapt to this by increasing their heart rate and breathing, but for those with weaker heart or lung function, it may lead to breathing difficulties or chest tightness.

Liu advised that people in the following situations avoid flying:

• Within 10 Days of Heart or Lung Surgery: Patients who have recently had heart or lung surgeries, such as stent placements or bypass surgery, should not fly within the first 10 days. After surgery, there may be residual gas in the chest cavity, which can expand in low-pressure environments, causing a pneumothorax (collapsed lung) that puts pressure on the lungs.
• Within Two Weeks of a Heart Attack: People who have had a heart attack in the past two weeks should also avoid flying. Studies show that the risk of a second heart attack is highest within two weeks, and a second occurrence can be even more dangerous than the first.

Tips for Safe Air Travel for Those With Heart Conditions

Liu offered the following advice for patients with heart conditions who are preparing to fly:

• Travel Only When Stable: Liu advised: “You should only fly if you’re not experiencing chest tightness, pain, or shortness of breath. If your heart is already under strain, it’s working hard to protect you, and the low-oxygen environment on a plane may be too much.” He also recommended that patients consult their doctors before flying to ensure they are fit for travel.
• Get Plenty of Rest Before Flying: Avoid strenuous exercise and sleepless nights before your flight. Arrive at the airport early to keep your schedule relaxed. A calm body reduces the risk of heart strain, as stress can overstimulate the sympathetic nervous system, increasing the risk of heart complications. Research shows that heightened sympathetic activity can lead to irregular heart rhythms.
• Take Medications Regularly: Carry your usual medications in your hand luggage and take them as prescribed. Liu suggested bringing a double supply and avoiding putting all medications in checked baggage, as delays or lost luggage could leave you without them. Taking blood pressure medications is especially important, as flying can elevate blood pressure. Patients should also bring emergency medications for angina, arrhythmia, and blood pressure control in case of sudden symptoms. Liu shared that he had helped two passengers with sudden discomfort on flights—one with severe dizziness and another with mild chest tightness—and both felt better after taking their own medication. He stressed that while emergency medicine might be available on board, using one’s own medication is usually more effective.
• Stay Hydrated and Watch Your Diet: The air on planes is often dry, which can thicken the blood. Liu suggested drinking water regularly, even before feeling thirsty. Also, avoid the salty, oily snacks usually served on flights, as these can affect heart health. It’s best to avoid alcohol and caffeine, as both can stimulate the nervous system and raise blood pressure.
• Request Oxygen in Advance: Patients with heart failure or chronic obstructive pulmonary disease may require supplemental oxygen. Liu recommended arranging for oxygen with the airline before the flight.
• Move Your Legs Frequently to Prevent Blood Clots: Prolonged sitting can increase the risk of blood clots, especially for heart patients. Regularly moving your legs during the flight can help blood circulation and reduce the risk of deep vein thrombosis.

The Dangers of Blood Clots

In addition to discomfort caused by the low air pressure in the cabin, prolonged sitting is a significant risk for cardiovascular patients. Studies have shown that the risk of venous thrombosis (blood clots) doubles after flying for more than four hours. Extended flight times or multiple flights in a short period further increase the risk of developing blood clots.

Liu explained that venous blood flow is slower, and leg muscle contractions help with blood returning to the heart. On flights, symptoms of a blood clot in the veins include noticeable pain, swelling, or even raised blood vessels and bruising in the calf, usually on one side. The most dangerous complication occurs if the clot moves to the pulmonary artery, causing a pulmonary embolism and breathing difficulties. “This is a serious danger during flights,” he emphasized.

For individuals who are obese, older, or have a family history of blood clots, long-haul travel requires extra caution. Liu suggested the following:

• Move Every Hour: Get up and walk around every hour during long flights to promote circulation.
• Elevate and Move Legs While Seated: While seated, try to elevate your legs and move them back and forth to encourage blood flow.
• Wear Compression Socks: Wearing compression socks helps improve venous return. If compression socks are unavailable, wearing thicker, longer sports socks can also be helpful, providing they cover the lower leg, ideally extending just above the calf and close to the knee.

Sun Exposure Can Help With Jet Lag Adjustment

In addition, heart patients may find that jet lag affects their blood pressure and causes disruptions in the autonomic nervous system, which can directly or indirectly increase the risk of heart attacks during long-distance travel. Liu suggested drinking plenty of water, getting sunlight during the day, and avoiding bright lights at night to promote melatonin production, which can aid sleep. He advised against using alcohol to cope with insomnia, as it can have the opposite effect. Taking melatonin supplements may also help regulate the body’s internal clock, but those with heart conditions should consult their doctor before using it.

Liu emphasized that heart disease should not overly restrict patients’ ability to enjoy life. He encourages patients, once they understand their health condition, to venture out and enjoy life as long as the risks are not too high.