A recent blog article entitled, “How High Is too High – Altitude and PAH” from pulmonology specialist Jeremy P. Feldman, published on the blog Pulmonary Hypertension R.N. is encouraging patients with pulmonary arterial hypertension to consult their physicians prior to airplane travel and exposure to high altitudes, noting that physicians can help PAH patients make the right decisions on a case by case basis.
Typically, doctors advise patients to avoid high elevations, which, according to Feldman, may lead to health issues. Patients who suffer from pulmonary hypertension, when exposed to high elevation or altitude, can suffer from a diminished amount of oxygen present in the air, which can in turn lead to lower oxygen in the lungs and the pulmonary arteries.
“Unfortunately this causes constriction or tightening of the pulmonary arteries. As the pulmonary arteries constrict, the right side of the heart has to work even harder to pump blood. Patients experience increased shortness of breath, fatigue and can even have fainting episodes. Patients often retain additional fluid while at higher elevation as well,” he explained in the blog article.
While PAH patients typically search for information on “how high is too high” concerning the issue of high altitude, Feldman notes that “there is no one number,” only that the risk of increased symptoms and worsening of PAH increases with an increase in elevation and altitude. Dr. Feldman goes on to explain that most patients can tolerate 3,000 feet above sea level, but that the 7,000-f00t mark is often the maximum safe elevation for those with PAH.
For those with PAH who are exposed to high altitudes, the use of oxygen can be useful in order to reduce the symptoms of the disease, since patients can increase the liter flow of their oxygen source. Another option to reduce PAH symptoms during periods of experiencing high altitude is to minimize exertion levels. However, Feldman believes that the most important precaution is for the patient to be aware of the risk of high altitude with PAH, and if the patient begins to not feel well, to return to a lower elevation and altitude.
“When you travel on an airplane the cabin is pressurized to about 7500 feet of elevation. That means that for the bulk of the flight it is as though you were visiting a destination 7,500 feet above sea level. Most patients can tolerate this for a short flight such as 2 hours. Transcontinental flights can be more dangerous,” Feldman explains.
The pulmonologist also notes that, most importantly, pulmonary hypertension patients should always check with a doctor prior to flying. In addition, for patients who need oxygen, forms must be filled out by a doctor in advance in order to authorize the transportation of a TSA-approved portable oxygen container.