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Travelling with cardio-vascular disease

Before departure
Before departure

Hardly any travel contra-indications exist for those with heart trouble, hypertension, pacemakers or coronary thrombosis. Even if your illness is serious, this should not stop you from travelling. You must meet three conditions: know and understand your own body and its reactions, follow to the letter your doctor’s prescriptions and, especially, know how to adapt your travel plans to your physical abilities and your illness.

Therefore the first obligatory step to your trip is to visit your heart specialist. This consultation should take place several weeks before you leave, or whenever you decide where you are going. At this time your cardiologist will evaluate the “acceptable” risks relative to your trip, and conduct a complete health test or certain tests like an electrocardiogram, a heart scan, physical fitness test, etc. He/she will also measure the compatibility of your habitual medications with the treatments you might have to follow during your trip (malaria pills, medication for diarrhoea, anti-inflammatories…) and the diet you will need to adapt to your condition. Your doctor will then tell you which situations to avoid: cold, heat, humidity, and high altitudes…

Take advantage of this occasion to review the main cardio-vascular risk factors (diabetes, high blood pressure, tobacco, cholesterol…). Ask your doctor to remind you of the symptoms, manifestations and warning signs relative to your illness. If you are familiar with these, you will be able to react appropriately and quickly by consulting a doctor in case of a problem, and on the contrary, you will be able to avoid useless worry and anxiety when facing benign symptoms.

Remember that for most cardio-vascular diseases stress and precipitation make a poor mix. Be ready on the day of your departure, and arrive early at the station or airport.

In case of a chronic illness or complicated previous medical history, ask your doctor to write up a medical report, preferably in English, that summarises your situation (background, description of your illness, past cases, results of recent tests, etc.) and mentions your usual treatment and its DCI. Also remember to bring a photocopy of your recent ECG (electro-cardiogram) with you.

Treatment

Never deviate from your usual treatment, not even in the airplane. Always have it with you and take a duplicate of your prescription specifying the international name of each of your medications: the DCI (common international name). For example, the DCI of aspirin is acetylsalicylic acid. This way you can replace it or quickly find its equivalent wherever you are.

Before your departure, your doctor will be able to:

  • Renew your personal treatment, add or remove certain medications, and adapt the amounts

  • Advise you about when to take your medication according to the hour change, particularly if you have made a very long flight

  • Prescribe and explain the use of various emergency medications that are critical for certain illnesses (coronaropathy, diabetes…).

Leave with a well-adapted treatment that you have followed for at least two weeks, and sufficient provisions. In fact, it would be very unreasonable to leave the day after you have introduced a new medication to your habitual treatment or made a significant change in the dosage. Don’t forget your spray or emergency medication.

In the airplane

The atmospheric environment inside an airplane is very particular. Even pressurised, the cabins of modern airline carriers climb to a relative altitude of 1,800 – 2,400 meters (5,400 – 7,200 feet). Oxygen is therefore more scarce than at sea level. A patient suffering from severe cardiac deficiency may not be able to tolerate these conditions, just as he/she may not be able to tolerate travelling to high altitudes. Your heart specialist will be able to warn you of the risks involved. During the flight, keep yourself hydrated by regularly drinking lots of water; avoid eating salty foods or salting your food.

To keep from getting phlebitis, loosen your clothing (which is loose-fitting already), avoid wearing tight trousers and lace-up shoes; remove your shoes and slip on a pair of comfortable socks. Do not stay in your seat the entire time, but get up regularly and walk around the cabin and up and down the aisles. If you cannot get up and walk around frequently, don’t hesitate to exercise in place, working all the different muscle groups in your lower limbs: your feet, calves and thighs. Then relax all your muscles and breathe deeply and slowly. Your family doctor can prescribe a treatment according to your situation to wear support hose, or for medication for stronger veins, even anti-coagulants.

At your destination

Remember that holidays are supposed to be restful. Limit your excursions, guided tours or intense physical activities, especially if you’re out of shape. After a long journey, plan on taking it easy for a few days and be sure to take regular time out during the rest of your vacation. Go to bed at a reasonable hour and don’t get up before dawn. 

Choose activities that are easy and pleasant, like walking. Avoid any radical change in diet and don’t overeat. Remember that salt contributes to high blood pressure and aggravates cardiac insufficiency. If you have any problem while travelling, don’t wait until you get home to consult a doctor. The regulating doctor of your assistance company is available to discuss any questions or doubts you may have about your health. He/she can provide useful advice, contact your family doctor and organize a consultation wherever you are. 

Some particular cases

It’s important that travellers on long-term anti-coagulant medication keep a very close watch on their treatment even during their vacation, and especially if their holidays are prolonged by several weeks. It’s essential to have the opinion of your heart specialist.  He/she may require that regular blood samples be taken on site and so it’s important to know in advance if these exams can be carried out locally.

It’s very important to take rigorous precautions to prevent secondary infections in travellers with valvular illnesses or who have heart valve prostheses: make an appointment to see your dentist a few weeks before leaving (to finish a treatment if necessary, to receive immediate treatment for any ear, nose or throat infection, as well as treatment for any skin wounds or infections. Contact the regulating doctors of your assistance company and/or consult for medical advice if the slightest, inexplicable fever occurs.

Travellers with pacemakers or defibrillator implants must verify that their device functions well before they leave. Avoid any violent sports and compressive elements such as backpack straps. Warn the security staff at the airport that you are fitted with a pacemaker, as well as for minor surgery (the electrical lancet can deregulate the pacemaker or set off the defibrillator implant in an untimely way.) Remember to take your pacemaker card with you, as it describes the type of casing, how it is regulated and the electrophysiological maintenance exams.