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Mikołajczak K, Czerwińska K, Pilecki W, Poręba R, Gać P, Poręba M. The Impact of Temporary Stay at High Altitude on the Circulatory System. J Clin Med 2021; 10:1622. [PMID: 33921196 PMCID: PMC8068881 DOI: 10.3390/jcm10081622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/04/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022] Open
Abstract
In recent times many people stay temporarily at high altitudes. It is mainly associated with the growing popularity of regular air travel, as well as temporary trips to mountain regions. Variable environmental conditions, including pressure and temperature changes, have an impact on the human body. This paper analyses the physiological changes that may occur while staying at high altitude in healthy people and in people with cardiovascular diseases, such as arterial hypertension, pulmonary hypertension, heart failure, ischemic heart disease, or arrhythmias. Possible unfavourable changes were underlined. Currently recognized treatment recommendations or possible treatment modifications for patients planning to stay at high altitudes were also discussed.
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Affiliation(s)
- Karolina Mikołajczak
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, PL 50-368 Wroclaw, Poland; (K.M.); (W.P.); (M.P.)
| | - Karolina Czerwińska
- Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, PL 50-368 Wroclaw, Poland;
| | - Witold Pilecki
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, PL 50-368 Wroclaw, Poland; (K.M.); (W.P.); (M.P.)
| | - Rafał Poręba
- Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, PL 50-556 Wroclaw, Poland;
| | - Paweł Gać
- Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, PL 50-368 Wroclaw, Poland;
| | - Małgorzata Poręba
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, PL 50-368 Wroclaw, Poland; (K.M.); (W.P.); (M.P.)
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Koh CH. Commercial Air Travel for Passengers With Cardiovascular Disease: Recommendations for Common Conditions. Curr Probl Cardiol 2020; 46:100768. [PMID: 33348221 DOI: 10.1016/j.cpcardiol.2020.100768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
The exponential growth of commercial flights has resulted in an explosion of air travelers over the last few decades, including passengers with a wide range of cardiovascular conditions. Notwithstanding the ongoing COVID-19 pandemic that had set back the aviation industry for the next 1-2 years, air travel is expected to rebound fully by 2024. Guidelines and evidence-based recommendations for safe air travel in this group vary, and physicians often encounter situations where opinions and assessments on fitness for flights are sought. This article aims to provide an updated suite of recommendations for the aeromedical disposition of passenger with common cardiovascular conditions, such as ischemic heart disease, congestive heart failure, valvular heart disease, cardiomyopathies, and common arrhythmias.
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Affiliation(s)
- Choong Hou Koh
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS School of Medicine, National University of Singapore, Singapore; Changi Aviation Medical Centre, Changi General Hospital, Singapore.
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Pearce E, Haffner F, Brady LB, Sochor M, Duchateau FX, O'Connor RE, Verner L, Brady WJ. Nonurgent commercial air travel after acute coronary syndrome: a review of 288 patient events. Air Med J 2014; 33:222-30. [PMID: 25179956 DOI: 10.1016/j.amj.2014.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/22/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We studied a population of individuals who experienced an acute coronary syndrome (ACS) event while traveling abroad and required nonurgent commercial air travel to the home region. METHODS This retrospective study gathered data from 288 patients enrolled in a travel-based medical assistance program. Interventions, complications, and travel home were assessed for trends. Descriptive and comparison statistical analyses were performed. RESULTS Two hundred eighty-eight patients were identified and entered into the review. Of the patients in this study, 77.1% were male with an average age of 67.7 years. One hundred sixteen (40.3%) patients were diagnosed with unstable angina pectoris (USAP), whereas the remaining 172 (59.7%) patients experienced acute myocardial infarction (AMI). Regarding inpatient complications during the initial admission, 121 (42.0%) patients experienced 1 or more adverse event. The average number of days after an ACS event that a patient began to travel home was 10.5 days for the entire patient population (USAP patients = 8.8 days, AMI patients = 11.8 days). Two hundred twenty (76.4%) patients traveled with a medical escort, and 48 (16.7%) patients received supplemental oxygen during air travel. Four (1.4%) in-flight adverse events occurred in the following ACS diagnostic groups: 2 in the complicated AMI group, 1 in the uncomplicated USAP group, and 1 in the uncomplicated AMI group. No in-flight deaths occurred. Nine (3.1%) deaths were noted within 2 weeks after returning to the home region. The deaths after returning to the home region occurred in the following ACS diagnostic groups: 2 in the complicated USAP group, 1 in the uncomplicated USAP group, and 6 in the complicated AMI group. None of the patients who experienced in-flight events died after returning to their home region. CONCLUSIONS Upon discharge, the vast majority of ACS patients who travel to their home region via commercial air do not experience adverse events in-flight; when such adverse events occur in-flight, these events do not result in a poor outcome. No in-flight deaths occurred; death occurred in a minority of patients after returning to their home region, particularly in the complicated USAP and AMI groups, who were planned readmissions to the hospital.
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Affiliation(s)
- Emily Pearce
- Grand Canyon National Park, Branch of Emergency Services
| | - Faith Haffner
- Allianz Global Assistance-Canada, Kitchener, Ontario, Canada
| | - Lauren B Brady
- Curry School of Education, University of Virginia, Charlottesville, VA
| | - Mark Sochor
- Allianz Global Assistance-Canada, Kitchener, Ontario, Canada; Department of Emergency Medicine, University of Virginia, Charlottesville, VA; Allianz Global Assistance-United States, Richmond, VA
| | | | - Robert E O'Connor
- Allianz Global Assistance-Canada, Kitchener, Ontario, Canada; Department of Emergency Medicine, University of Virginia, Charlottesville, VA; Allianz Global Assistance-United States, Richmond, VA
| | | | - William J Brady
- Allianz Global Assistance-Canada, Kitchener, Ontario, Canada; Department of Emergency Medicine, University of Virginia, Charlottesville, VA; Allianz Global Assistance-United States, Richmond, VA.
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Duchateau FX, Burnod A, Josseaume J. Évacuation sanitaire aérienne et rapatriement. MEDECINE INTENSIVE REANIMATION 2014. [DOI: 10.1007/s13546-014-0903-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Izadi M, Alemzadeh-Ansari MJ, Kazemisaleh D, Moshkani-Farahani M. Air travel considerations for the patients with heart failure. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e17213. [PMID: 25068047 PMCID: PMC4102980 DOI: 10.5812/ircmj.17213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 03/02/2014] [Accepted: 03/16/2014] [Indexed: 12/04/2022]
Abstract
Context: Prevalence of patients with heart failure (HF) is increasing in worldwide, and also the number of people with HF traveling long distances is increasing. These patients are more prone to experience problems contributed air travel and needs more attention during flight. However, observational studies about problems of HF patients during flight and appropriated considerations for them are limited. Evidence Acquisition: We evaluated the conditions that may be encountered in a HF patient and provide the recommendations to prevent the exacerbation of cardiac failure during air travel. For this review article, a comprehensive search was undertaken for the studies that evaluated the complications and considerations of HF patients during flight. Data bases searched were: MEDLINE, EMBASE, Science Direct, and Google Scholar. Results: HF patients are more prone to experience respiratory distress, anxiety, stress, cardiac decompensation, and venous thromboembolism (VTE) during air travel. Although stable HF patients can tolerate air travel, but those with acute heart failure syndrome should not fly until complete improvement is achieved. Conclusions: Thus, identifying the HF patients before the flight and providing them proper education about the events that may occur during flight is necessary.
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Affiliation(s)
- Morteza Izadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Mohammad Javad Alemzadeh-Ansari, Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9166174016, E-mail:
| | - Davood Kazemisaleh
- Department of Cardiology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Barros A, Duchateau FX, Huff JS, Verner L, O'Connor RE, Brady WJ. Nonurgent commercial air travel after nonhemorrhagic cerebrovascular accident. Air Med J 2014; 33:106-108. [PMID: 24787513 DOI: 10.1016/j.amj.2014.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/29/2014] [Accepted: 02/09/2014] [Indexed: 06/03/2023]
Abstract
Nonurgent commercial air travel in patients who have experienced a nonhemorrhagic cerebrovascular accident (CVA) may occur, particularly in the elderly traveling population. A recent CVA, particularly occurring during a person's travel, presents a significant challenge to the patient, companions, family, and health care team. Specific medical recommendation, based on accumulated scientific data and interpreted by medical experts, is needed so that travel health care professionals can appropriately guide the patient. Unfortunately, such recommendations are almost entirely lacking despite the relative frequency of CVA and air travel. This article reviews the existing recommendations with conclusions based on both these limited data and rationale conjecture.
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Affiliation(s)
- Andrew Barros
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA
| | | | - J Stephen Huff
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA; Allianz Global Assistance France, Paris, France; Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA; Allianz Global Assistance USA, Richmond, VA
| | | | - Robert E O'Connor
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA; Allianz Global Assistance Canada, Kitchener, Ontario, Canada; Allianz Global Assistance USA, Richmond, VA
| | - William J Brady
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA; Allianz Global Assistance Canada, Kitchener, Ontario, Canada; Allianz Global Assistance USA, Richmond, VA; Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA.
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