The plane was hot. Finally, after more than an hour waiting on the tarmac, the plane began to taxi toward the runway. Suddenly, an attendant light dinged and quickly thereafter the plane turned back to the airport. As frequent flier Mellanie True Hills suspected, someone in the back of the plane was experiencing heart issues, a situation becoming more and more common on flights. Frequent fliers often struggle with jet lag, and staying healthy on the road. Did you know air travel can trigger a heart related emergency? It’s true, but it can be simple to prevent, or at least significantly limit the risks. Road warrior and heart arrhythmia expert Mellanie travels the world racking up as many as 60,000 miles in 60 days isn’t surprised heart rhythms issues and even heart attacks on flights are increasing. “Tightly packed passengers are less likely to want to inconvenience fellow travelers, so many choose not to drink anything during flights to avoid having to get up to visit the restroom. Dehydration and being sedentary both can trigger heart problems.” Mellanie’s concerns about air travel are both personal and professional. Diagnosed with atrial fibrillation, the most common abnormal heart rhythm, she is vigilant about staying hydrated and active on flights to protect her heart. Professionally, she is the CEO of StopAfib.org, patient advocacy organization that hosts the number one arrhythmia site and one of the top five heart disease sites worldwide. Mellanie points to three areas of concern for frequent fliers:
- Dehydration during flight can trigger abnormal heart rhythms and Holiday Heart Syndrome
- Long periods sitting can cause deep vein thrombosis (DVT)
- Changing air pressure can trigger heart attack
Dehydration and Your Heart
The significantly dry air on a plane wicks moisture out of the body, causing dehydration quickly. Dehydration thickens the blood and depletes the body of essential minerals such as potassium and magnesium. Both of those minerals regulate heart rhythm. Inadequate levels of potassium or magnesiums can trigger abnormal heart rhythms, including atrial fibrillation (Afib). “If your heart has ever felt like a flopping fish, a bag of wiggly worms, or fluttering butterflies, you may have atrial fibrillation [aka Afib], the most common irregular heartbeat. You can find out more about how to tell at StopAfib.org,” says Mellanie. For some people, Afib symptoms are fleeting and disappear on their own. However the abnormal rhythm can cause blood to pool in the heart and form a clot. Already thickened blood from dehydration makes this more likely. That clot could then travel to the brain and cause a stroke. Afib is just one of many types of abnormal heart rhythms, including holiday heart syndrome. Named because emergency rooms see an increase of people with heart trouble during holidays such Christmas, New Year’s day, spring break, and Super Bowl Sunday. Overindulgence in food and alcohol causes an abnormal rhythm and chest pain. Business travelers, especially those traveling to conferences, often have the same overindulgence issues. Adding dehydration to the mix can trigger chest pain, which should not be ignored.
What should travelers do?
“Drinking mineral water, or even club soda, not only keeps you hydrated, but also replaces the minerals you are losing. I think jet lag is mostly caused by dehydration, and by drinking mineral water both during the trip and when I arrive, I rarely suffer from it even when traveling internationally.” Mellanie suggests drinking at least six to twelve ounces per hour of on the plane. Yes, this means you will have to get up and use the restroom. Which in itself is a good way to avoid DVT.
The Risks of Sitting
Sitting in one position puts travelers at risk of DVT, a condition during which blood clots form and block the flow of blood. Coupled with thickened blood due to dehydration, sitting for long periods sets travelers for DVT in the legs. DVT however can form anywhere in the body and are particularly dangerous when formed in the lungs or travel to the brain causing a stroke.
What should travelers do?
In addition to staying hydrated, stand and move around the plane at least once per hour.
Air Pressure and Your Heart
Oxford University studied the affect of lower air pressure when flying on blood pressure. The study found an increase in blood pressure in the lungs, which is concerning. This increase in blood pressure, combined with dehydration and sitting could spell disaster for someone with already elevated risk factors such as high blood pressure. In a study published in the American Journal of Cardiology Dr. Philip Houck, co-chairman of the cardiology division at Scott and White Hospital and the Texas A&M College of Medicine and his team of emergency room doctors noted they saw more patients with heart attacks when thunderstorms caused the air pressure to drop significantly. Commenting on the study, Dr. Houck explained, “My experience taking care of patients over the years told me that the day after a major weather event, like a thunderstorm, we would see a cluster of heart attacks. Our study now shows that a relationship does exist “The more the pressure falls, the greater the chance someone has of having a heart attack the next day,” The study also indicates the rapid drop in air pressure in an airplane could have the same results.
What should travelers do?
First, understand your personal risk of heart attack and heart disease. If you are on medication for high blood pressure, or any other heart disease risk factor, take it consistently while traveling. If you have symptoms during travel, get help. Never ignore chest pain, shortness of breath, dizziness, or a sudden, intense, or unusual pain anywhere in the head, neck, back, shoulders or torso.
That all sounds scary. Is air travel too risky?
As a frequent flier, Mellanie certainly isn’t too scared to fly, but she also doesn’t take the risks lightly either. “The trick is to stay on top of dehydration. Frequent fliers, do yourself a favor. Pick up a big bottle of mineral water in the gift shop!” Sipping as you travel will protect your heart, and may even ward off jet lag too.
