Pulmonary hypertension (PH) is caused by high blood pressure in the lungs, which is caused by narrowed and thickened pulmonary arteries. Because of the added effort needed to pump blood through the narrowed arteries, the heart becomes enlarged and weakened in PH, which can result in right heart failure, particularly if exacerbated by other medical conditions or external factors like altitude or flying.
Despite the fact that patients with pulmonary hypertension are not prevented from flying, it is important to be aware of the limitations caused by the disease and that there are some risk factors associated with flying. As a result, patients need to make additional arrangements before flying, taking into consideration the effects that altitude and weather can have on the body. By knowing the risks of flying with pulmonary hypertension, patients can discuss the best approaches for mitigating these risks with a physician.
Risks associated with flying with PH
High altitude, whether from flying or by visiting high places, is particularly challenging for patients with pulmonary hypertension since there is lower pressure in the atmosphere, which causes lower oxygen levels in the blood in both healthy people and PH patients. At high altitude, the blood vessels in the lungs become constricted and pulmonary pressure increased, resulting in what people often refer to as “thin air.” Due to the stress of flying, the symptoms of the disease can be exacerbated and patients can experience limitations of movement.
The study “Effects of commercial air travel on patients with pulmonary hypertension air travel and pulmonary hypertension” revealed that hypoxemia, an abnormally low level of oxygen in the blood, is common among PH patients flying, occurring in about one-quarter of PH patients due to lower cabin pressures, ambulation during flight, and longer flight duration. There are other factors that can exacerbate the worsening of the symptoms at high altitudes, including a genetic predisposition to respond abnormally to low oxygen called hypoxia. Lower humidity and very dry air while flying can also exasperate the lungs.
Recommendations for flying with PH
Despite these limitations, there are several tips that can help overcome problems associated with flying with pulmonary hypertension and prevent complications. The Pulmonary Hypertension Association’s (PHA) Scientific Leadership Council has issued a Consensus Statement that, together with consulting a specialized physician, can help patients fly safely. The organization advises patients to consult with their doctor about specific medical PH requirements prior to departure, which can simplify the process of obtaining oxygen and getting medicine through security checkpoints.
Supplemental oxygen can be an option to address the low blood oxygen level, while having the name of a physician familiar with PH at the travel destination can be helpful in case of emergency. While traveling, patients should stand up and walk a short distance at least every two hours, and should bring extra medicines and supplies in carry-on luggage in case of delays. Reserving a seat in advance can guarantee a place with good leg room and eases the stress of check-in. In addition, the PHA advises patients not to underestimate the strain of flying, and to take it easy, plan plenty of time during layovers and ask trusted travel companions to do tasks like carrying bags, providing wheelchairs, or arranging gate-to-gate transportation.
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