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Hotelsinitaly.biz: Tips for travellers with heart disease

 

 



TRAVELING WITH HEART DISEASE

 

 

 

 

 


   

   

Are you coming soon here to visit our Country ? How does travel affect your heart if you have heart disease? Depending on your health condition, there are several factors to consider when planning your next trip.

Medical Considerations:

Before you leave, the first and most important step for all heart patients is to have a complete physical exam and get an accurate assessment of your current physical health.

Most people with stable heart disease that is monitored and controlled should have no problem traveling; however, travel is not recommended for people with uncontrolled angina, abnormal heart arrhythmia, or uncontrolled congestive heart failure (CHF). If you have had a heart attack within the past four weeks, or open heart surgery within the past two to six weeks, air travel is not recommended.

Different types of heart disease require different precautions. For example, people with CHF should avoid high altitude destinations. Check with your doctor about precautions that are important to your own health condition.

You should also consider getting vaccinated for influenza and pneumococcus.

Getting Ready

Once you’ve had your physical and notified your doctor of your travel plans, it is a good idea to document the following medical information and keep it with you at all times:

Pack and carry more than enough of each of your medications to cover the length of your trip as medication may be difficult to refill once you reach your destination. Keep all medications in their original containers. Pack all of your medical information and medications in your carry-on luggage to avoid losing them in misplaced luggage.

In the Air:

Each year some 1.6 billion passengers are carried by domestic and international airlines in some 15,000 jet aircraft flying some 20 million hours. That this is accomplished with the accidental loss of an average of only 1,200 lives makes aviation a safer means of transport than road and is a tribute to the competence and professionalism of the industry.

Such a large exposure of people over such a time frame makes it inevitable that if death or illness occurs in the home, or in the workplace, it may also occur during travel. This is of concern for a number of reasons: the cabin environment is not a favourable place in which to be unwell, since the patient may be hours away from hospital services, and, from the operational viewpoint, diversions are both costly to the airline and inconvenient to others. This last point particularly applies to the proposed ultra-long haul (up to 18 hours), sometimes transpolar, sectors.


FLYING AND THE CABIN ENVIRONMENT

Even seasoned travellers find flights stressful: parking at the airport, the crowds of people, carrying belongings long distances, delays at check in and at departure. Up to one third also will express some unease about leaving the ground. The cabin micro-environment, whilst protected, is not a normal one. The cabin altitude is maintained at between 6,000 – 8,000 feet (1,676 – 2,438 metres). At sea level a barometric pressure of 760 mmHg gives an arterial PaO2 of 103 mmHg (13.7 kPa) when breathing air. At 5,000 feet (1,525 metres) the barometric pressure will be 565 mmHg and the PaO2, on air, 75 mmHg (10.0 kPa). At 8,000 feet (2,438 metres) the figure will be 65 mmHg (8.7 kPa).

The oxygen dissociation curve of normal haemoglobin is such that 90% saturation of haemoglobin is still achieved at cabin altitudes but whilst this is tolerable for a healthy individual it may not be so if tissue perfusion is for any reason inadequate. Other problems include low humidity - there is little moisture in the air at altitude - noise, vibration, limited space and changes in circadian rhythm.


CORONARY HEART DISEASE AND FLYING

The coronary syndromes span an occasional episode of chest pain, frequent angina, unstable angina and myocardial infarction. Symptoms may be absent either on or off treatment and breathlessness may represent an “angina equivalent”, or, be due to significant left ventricular dysfunction with or without pulmonary oedema.

The coronary pathology may be quite minor and localised or more severe and involve all three coronary vessels. Finally the left ventricle may be intact, or more severely damaged. From this range of possibilities, those advising patients about flying have to give a responsible view about whether or not it is appropriate to fly. In general, if a patient can manage a flight of stairs without stopping and without significant symptoms whilst holding a conversation, he/she should be fit enough to fly.

Patients with frequent (i.e. daily) angina should be discouraged from flying and those with an unstable syndrome should not fly. There need be no bar for those with mild stable angina but travel should be delayed for three weeks or so following a recent myocardial infarction by which time convalescence should be nearing completion. A stable old myocardial infarction should not be a problem, but it is worthwhile informing the airline medical branch.

Following coronary surgery limiting factors include the stability of the sternal wound and the need for the resorption of air from the pleural cavity – usually about two weeks. By contrast, the symptom-free patient following coronary angioplasty/stenting should be fit enough to travel after 1-2 weeks. In the event of significant left ventricular dysfunction/failure flying is contraindicated if oxygen is needed at rest on the ground. Patients should be encouraged to keep plenty of their usual medication with them, including nitroglycerine. It is also wise to take a prescription (for the customs officer), and a medical report. Dosing frequency should be maintained across the time zones.


AIRLINE MEDICAL SERVICES AND IN-FLIGHT MEDICAL CARE

All the major airlines have medical branches and invite passengers, and their medical attendants to advise them of possible problems of a medical nature. Airport medical services can make trolleys or wheel chairs available, if needed, but giving them prior warning is advisable. Medical or nursing escorts can be requested, but have to be paid for by the patient.

On board oxygen (which is separate from the emergency system) should be requested well in advance to ensure an adequacy of supply if there is frequent angina or a reduced Pa02 at ground level. Occasionally, myocardial infarction will occur whilst in the air, and about half of all deaths will occur within the first 15 minutes from an arrhythmia. Cabin staff are trained for such an emergency and all airlines carry first aid and medical emergency kits.

Most major airline flights are now equipped with a “smart” in-flight defibrillator. Nevertheless, even with a defibrillator at hand, the chances of successful estoration of a satisfactory rhythm and eventual discharge from hospital are limited. It is for that reason, that careful assessment of patients with coronary heart disease is so important.

On the Ground:

When you arrive at your destination, be sure to pace yourself and avoid highly strenuous activities and unnecessary stress. Certain activities, such as scuba diving, are extremely risky for heart patients and not recommended.

If you take diuretics, stay hydrated, and try to monitor your salt intake when eating out. If you are taking blood thinners (such as Coumadin [warfarin]), do not eat excessive amounts of green leafy vegetables; they contain high levels of vitamin k, which helps the blood to clot, and may interfere with the effectiveness of your medication.

Most of all, try to relax, and enjoy your trip!

 









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  • http://www.sorrento.cc




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    Home |  Good Tips | About Pets | Wild Flora and Fauna | Charter of the tourist rights |  Rights of the flight passengers | Hotel Contract | Hotel Symbols | Diabetes | Heart disease |  Dialysis | Pros and Cons |  Partner links |  Contact us

    http://www.tredy.com
    http://www.tredytours.com
    http://www.resortsinitaly.com
    http://www.pompeii.org.uk
    http://www.italy-tours.org
    http://www.sorrento.cc