Holidays and travel

Going on holiday should be an enjoyable time which gives you the chance to relax, rest and unwind.

However, if you have recently had a cardiac condition, such as a heart attack, or been in hospital for a procedure or heart surgery, it's best to wait until you feel recovered before going on a holiday.

Is it safe for me to go on holiday?

Most people with a heart condition are able to go on holiday. If your heart condition is stable, well controlled and you feel well, you should be okay. However, when you are planning your holiday you should think about:

• staying in accommodation that is easily accessible and close to any amenities
• avoiding destinations that are hilly, unless you are confident that you are recovered and fit enough for that level of activity
• keeping an up-to-date list of all your medication and doses in your purse or wallet, just in case you lose any of them, including the generic and brand name of your medicines
• taking enough medications with you to last throughout your holiday
• (if you are travelling by air or going overseas) getting a letter of explanation from your GP regarding your condition, drugs, allergies and any devices you have (eg, pacemaker)
• and making sure you have adequate travel insurance.

Getting to your destination

The most stressful part can sometimes be getting to and from your holiday destination. There are lots of things you can do to reduce any problems you might get from travelling, such as:

• planning your route and allowing plenty of time for whichever form of transport you are taking, so that you're not rushed
• using bags and suitcases on wheels so that you don't have to carry heavy luggage.

How soon after a heart event or heart surgery can I go on holiday?

If you've recently had a heart event such as a heart attack, heart surgery or been unwell, it's best to wait until you are recovered. For many people this can be several weeks. Your GP or heart specialist will be able to advise and guide you on when you are well enough to go on holiday.

Can I travel by air?

According to expert guidance from the British Cardiovascular Society, the majority of people with heart and circulatory disease can travel by air safely without risking their health.

However, you should always check with your GP or heart specialist as to whether you are fit enough to travel by air, particularly if you have recently had a heart attack, heart surgery or been in hospital due to your heart condition. This guidance provides your GP or heart specialist with information to help them advise you on your fitness to fly.

If you are given the go ahead to take a holiday that involves air travel, and think you will need particular assistance at the airport terminal or during the flight, then let the airport or airline know well in advance. This may include help with your luggage or early boarding to the plane.

If you need to, it is safe to use your GTN spray while you are on the plane, though due to recent security alerts you may be restricted in what liquid form medication you can carry in your hand luggage so check with the flight operator.

If you are flying through times zones, it may be difficult to keep to your pattern of taking your medications. Your GP or Practice Nurse will be able to advise you on how best to deal with this.

Am I safe to walk through the airport security systems?

If you have a pacemaker or an ICD you should take your device identification/card with you and inform the airport staff that you have a device inserted. If you are asked to pass through the security system, walk through at a normal pace and don't linger.

Most modern pacemakers and ICDs are well shielded against outside interference and so interference is very unlikely, although the metal casing may trigger the security alarm. If a hand-held metal detector is used, it should not be placed directly over your device for longer than is necessary and sweeping repeatedly over your device should be avoided.

The Medicines and Healthcare Products Regulatory Agency (MHRA) can provide you with further advice and information on the safety aspects of airport security systems when you have a pacemaker or an ICD.

What about very hot and cold climates?

It's best to avoid going to countries where there are extreme temperatures, whether it's very hot or very cold, as this can put an added strain on your heart.

Can I travel to high altitudes?

It's advisable to avoid travelling to high altitudes as the higher you go above sea level, the less oxygen there is in the air.

This means that less oxygen will be carried in your blood and when you have a heart condition the reduced oxygen level in the blood can cause extreme breathlessness or angina. The higher a destination is above 2,000 metres the more likely you are to experience breathlessness or headaches.

If you do plan to travel to a high altitude destination, get advice first from your doctor or heart specialist.

Am I at risk of Deep Vein Thrombosis (DVT)?

For most people the risk of developing DVT while travelling by air is very low. However, if you have previously had DVT or had recent surgery then your risk of developing the condition is higher and you should speak with your doctor before travelling anywhere by air. If they advise you to wear support stockings for the flight, ensure they are the right size for your leg and calf measurement.

To help reduce your risk of a DVT you should:

• try to keep mobile during the flight by periodically walking up and down the aisle
• do flex and extend exercises with your legs and feet
• make sure you are well hydrated before you fly
• during the flight, keep hydrated and avoid drinking alcohol and caffeine.

If you are considered to be at high risk of developing a DVT, then a blood thinner heparin injection may be considered by your doctor.

However, you should not take aspirin or any other medication to thin the blood without seeking advice from your doctor first. If you take aspirin regularly on prescription, you should continue to take this as directed by your doctor.