1. Hearts in the sky: understanding the cardiovascular implications of air travel.
- Author
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Katoch, Tavishi, Pinnamaneni, Sravya, Medatwal, Raunak, Anamika, FNU, Aggarwal, Kanishk, Garg, Shreya, and Jain, Rohit
- Abstract
Air travel is widely regarded as the safest mode of transportation, with the United States leading in airline passengers. However, travelers with pre-existing heart conditions face acute cardiovascular risks. Flight pilots and cabin crew are particularly vulnerable to air travel's physiological changes, which can significantly impair their health and performance. Cabin pressure differences and reduced oxygen levels at cruising altitudes of 5000–8000 feet make air travel challenging for individuals with underlying cardiac and pulmonary problems. This, along with dry air, sleep deprivation, missed medication and prolonged sitting, can lead to physiological changes. In-flight and pre-flight stressors contribute to increased health issues, and studies show a rise in medical emergencies during flights. Prolonged exposure to the airplane environment can lead to various health issues for pilots and cabin crew. These changes include impaired judgment, cognitive function and discomfort in the sinuses and ears due to pressure differentials. Therefore, thorough medical screening, skilled instrument use and compliance with safety measures are essential to mitigate these risks. This article reviews the cardiac implications of air travel, discussing the underlying pathophysiology, associated risks and preventive measures to ensure safer flights for individuals with cardiovascular diseases. Plain Language Summary This review examines the health risks of air travel for individuals with heart and lung conditions. Changes in cabin pressure and oxygen levels can lower blood oxygen, causing discomfort and health issues. Dry air, sleep problems and prolonged sitting also affect those with existing conditions. Pilots and flight attendants are especially vulnerable due to their continuous exposure. The authors reviewed how air travel impacts heart and lung health and found that in-flight medical emergencies are rising, affecting passengers and flight staff. Common issues include impaired cognitive function and discomfort from pressure changes. The article emphasizes the importance of pre-flight medical check-ups, carrying medical documents and having travel insurance. It also calls for thorough medical screening and skilled instrument use to ensure safety. Results show that current air travel conditions pose significant health risks for those with cardiovascular diseases. The study advocates for improvements in in-flight medical technology, cabin environments and personalized healthcare solutions to enhance safety. These findings suggest that future air travel should focus on reducing cardiovascular complications through advancements in medical support and cabin design. The study provides valuable insights into the physiological effects of flying and recommends measures to make air travel safer for people with heart and lung conditions. It highlights the need for ongoing research and collaboration among healthcare professionals, researchers and aviation authorities to address these health risks effectively. Article highlights Introduction Over 2.3 billion people travel by plane annually, with an increasing number of travelers having chronic medical conditions. The aging population will result in more passengers with cardiovascular diseases and other chronic conditions. Pathophysiology Reduced oxygen pressure at high altitudes can cause hypobaric hypoxia, impacting individuals with pre-existing conditions. Acute altitude exposure increases sympathetic activity, potentially worsening symptoms in those with cardiovascular diseases. Cardiovascular response Altitude exposure increases heart rate and cardiac output, which may exacerbate ischemic symptoms in individuals with heart disease. Anemia and pre-existing cardiac conditions can worsen hypoxic symptoms during flight. Pulmonary response Reduced partial pressure of oxygen increases alveolar ventilation and pulmonary artery pressure. Immobility during flights increases the risk of venous thromboembolism (VTE) and pulmonary embolism (PE). Prevention Patients with severe heart failure should avoid air travel when possible. Supplemental oxygen and avoiding high-sodium meals can help mitigate risks during flights. Mild physical activities and proper hydration are recommended to prevent VTE. Future perspective Innovations in in-flight medical technology and monitoring systems could improve safety for passengers with cardiovascular conditions. Future airplane designs may better control air pressure and oxygen levels, reducing stress on the cardiovascular system. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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