Traveling with Congenital Heart Disease
Travel is part of our life—but it can be stressful. The key to having a successful trip, whether by car, train, bus, airplane or boat, is to plan ahead and be prepared.
This way, your trip will be less tense and more relaxing and fun. Below are some general tips that you might find helpful:
- Discuss your travel plans with your ACHD care team as early as possible. Make sure that any outstanding health issues such as warfarin therapy, establishing anti-arrhythmic therapy, and pacer checks are addressed before embarking on your journey.
- Ask your cardiologist to write a letter about your CHD for you to carry and to give you a recent EKG. Carry the ACHA Personal Health Passport with you. It is also a good idea to carry extra prescriptions with you in case you lose your medications.
- Keep the ACHA Travel Directory with you in case you find yourself in a position of needing care from an ACHD cardiologist.
Consider buying travel insurance and look for a plan that allows you to cancel your trip for any medical reason or care (including pre-existing condition). You might also want a plan that covers trip interruption, lost baggage, medication, and/or medical evacuation, including flight to appropriate hospital.
Climate & Destination
Choose an appropriate climate and destination for you. Some secondary issues, such as pulmonary arterial hypertension, may affect your blood oxygen levels when flying or traveling to high altitudes.
- If you use oxygen, check with the airlines, train or bus company, cruise line, etc., prior to booking to make arrangements.
- If you don’t use oxygen, ask your ACHD cardiologist if you might need it on your trip.
Make sure you are not physically or emotionally exhausted before embarking on your trip.
- Arrive early to airport and avoid rush.
- Schedule a rest day after arriving particularly if you are traveling overseas.
- Consider arranging airport transfer.
- If traveling by train or air, ask for help with your luggage and ask the flight attendant for help putting your luggage in the overhead bin.
- If flying or traveling by train, board early and arrange for wheelchair assistance if needed.
- Travel with a companion.
- Pack lightly and use rolling luggage.
- Avoid wearing tight clothes and shoes as they limit venous return and increase swelling. This can increases dizziness and light headiness.
- Carry protein and healthy snacks and water with you.
Sitting for long periods of time increases the risk of swelling in your legs and developing blood clots (deep vein thrombosis or DVT).
- If driving, stop, get out and walk for 5-10 minutes every 1 ½ to 2 hours.
- If flying, walk in the aisle if the flight is more than hours. If it’s difficult to get up and walk, then move your feet for several minutes every hour.
- Consider wearing compression (support) travel socks.
- Avoid dehydration by drinking plenty of non-alcoholic beverages and non-caffeinated beverages, especially water. Flying, in particular, is dehydrating. Alcohol increases dehydration, especially in cyanotic heart disease.
- On the airplane, ask to sit in aisle seat. This encourages you to get up and walk.
- Adjust your diuretics as necessary whether traveling by car, train, or airplane.
If you take medication:
- Bring an up-to-date list of all medicines (brand and generic names) and doses and keep this list separate from your meds. You may want to email it to yourself. It’s also a good idea to have the telephone number and name of your pharmacy handy.
- If you take liquid medications, bring a note from your doctor and be sure to keep it in a bottle labeled by the pharmacy. If the medicine needs to be refrigerated, travel with a cooler.
- Do not place medications in your checked luggage. Carry them with you.
- Be prepared for travel delays. It’s a good idea to bring an extra week’s worth of medication and supplies you might need.
If you are flying and have a pacemaker or ICD:
- Carry your device ID with you and tell the TSA agent that you have pacer or ICD.
- With most pacemakers, it’s safe to walk through metal detectors now; it’s a good idea to check if yours is one of these. Walking through the full body scanner will not harm your pacemaker either.
- Do not allow a hand-held metal detector over your device.
- If in doubt, ask for a hand search by a TSA agent.
If you have a stent, it is safe to walk through metal detectors or full body scanners. While metal detectors will not pick it up, full body scanners will. Carry a note/device card in your wallet.
When you arrive at your destination:
- Know your limitations; your energy and activity level will be the same as it is at home.
- Don’t overexert yourself. If you are going to be active, gradually increase your exercise tolerance.
- Use good judgment with food and alcohol consumption. Bring snacks and water when sightseeing.
- Don’t make changes to your diet, particularly. Alcohol can affect the absorption of certain medication and can increase arrhythmias.
- Avoid stimulant drinks as they can cause an instant rise in BP and HR.
- Eating in restaurants is a part of traveling. Ask for your food to be prepared without added salt or any seasonings that may contain salt, such as soy sauce, grill bases, etc.
If you are cruising, there are a few additional steps you can take to assure that you have a successful trip:
- You may want to talk with the cruise line about pre-existing medical needs (such as special diet, oxygen, or wheelchair) prior to booking.
- Purchase medical evacuation insurance (up to $25,000) and/or buy travel insurance that covers health-related issues.
- Cruise on ships that are members of the International Council of Cruise Lines. The on-board doctor should have at least 3 years experience or board certification and skills in minor procedures
- Know the location of the ship medical facility and find out what the office hours are and if they have 24-hour ER service
- Before booking, ask if the ship has a pharmacy and laboratory, as well as basic medical equipment and supplies, including but not limited to: X-ray equipment, airway equipment, EKG machines, cardiac monitors, automated external defibrillators (AED), pacing, pulse oximeters and oxygen.
- Newer cruise lines generally have telemedicine and AEDs on board; some have helicopter pads.
- Carry a copy of your medical history and last clinic note.
- Remember that the ship’s doctor is boss and if he/she says you need to be evacuated, you will be evacuated.
When you travel, you will want to avoid stress; know your limitations; carry your medications (and extra doses) with you; and bring a letter from your ACHD doctor with information about you, your last clinic note, a recent EKG, a list of medications, and the ACHA Health Passport and Travel Directory. Most importantly, when you travel, have fun!