Safety of commercial air travel following myocardial infarction

Travelers occasionally suffer myocardial infarction (MI) while abroad. Existing guidelines recommend a 4- to 24-week convalescent period following MI before air travel should be permitted.

Air travel may be undertaken safely in the early post-MI period.

The aeromedical transport records of two international medical assistance companies over a 3-yr period were reviewed. We identified 209 patients who suffered MI; 13 transported by private air ambulance were excluded. We reviewed the aeromedical transports of the remaining 196 adults carried on commercial aircraft between 3-53 d post-MI to investigate the safety of air travel in this group. Data were recorded regarding patient age; sex; location of MI; complications of MI; presence of medical escort; duration of flight(s); use of oxygen, medications, or cardiac monitoring during transport; and development of symptoms in flight.

Within 7 d of their acute MI 3 patients (2%) were transported; 87 (44%) between days 8-14 post-MI; 65 (33%) between days 15-21; 27 (14%) between days 22-28; and 14 (7%) more than 28 d post-MI. Some 187 patients (95%) were transported without incident; 9 (5%) patients experienced symptoms requiring evaluation by the escorting physician. Of the 9, 6 problems occurred in patients being transported less than 14 d post-MI. Symptoms resolved spontaneously or immediately after physician intervention in all but one case.

International aeromedical transport of patients may be safely accomplished 2-3 wk after an acute MI when an accompanying physician is present. Recommendations for delaying travel more than 4 wk after infarction are not supported by clinical experience and should be revised.