How to Stay Heart Healthy while Traveling

As a cardiologist who works at an international hospital, I have seen a number of patients who have come to visit China as a tourist—and have ended up experiencing a major cardiac event while visiting. The most common cardiovascular emergencies include heart attack, arrhythmia (irregular heartbeat), syncope (fainting due to low blood pressure), heart failure, hypertension (high blood pressure), and pulmonary embolism (major lung artery blockage). It goes without saying that not only are these events an obvious damper to your vacation plans, but they can quickly become critical or even life-threatening, especially if you are an older tourist.

Traveling has been associated with an increased incidence of cardiovascular events among adult travelers who have existing cardiopulmonary diseases. Mortality studies indicate that cardiovascular disease accounts for most deaths during travel with in-between 50-70% of deaths, while injury and accident follow far behind with around 25%. Infectious disease accounts for about 3-4% of deaths during or from travel. Older individuals represent a substantial proportion of international travelers, and due to physiological changes and the increased probability of underlying medical conditions, older travelers are at a higher risk for many travel-related diseases. Based on this data and my own personal experiences as a cardiologist, it is necessary for the elderly to undergo a health checkup before traveling abroad in order to check for potential underlying health conditions.

As a cardiologist, here are my top tips for older travelers to follow before travelling:

1. Assess your cardiovascular status and risk prior to travel

This represents your first step in the evaluation process. Set an appointment and visit your Family Medicine Physician or Cardiologist to obtain some basic medical information such as your blood pressure, heart rate and rhythm, baseline EKG, as well as some basic cardiovascular evaluations including for angina pectoris (chest pain), congestive heart failure, and myocardial infarction (heart attack).

For those who have chronic pulmonary or cardiovascular conditions, seek special counseling to determine how your international flight might affect your condition. Request an echocardiogram to evaluate your heart function as well as the condition and functionality of your heart’s valves, walls, and chambers.

Undergo a stress test to check your exercise capacity—to see if you can go on longer excursions or walk through long airports—and assess your potential for myocardial ischemia (coronary heart disease).

If you have knee problems and are unable to do exercise, then take a Pharmaceutical Stress Test or the Myocardial Nuclear Test, other options for screening potential underlying coronary artery disease.

Carry the test results with you while you travel, as this information can greatly assist local doctors you may need to see on your trip and help you avoid taking repeated tests.

2. Heart medicine preparation

Make sure you have sufficient anti-hypertensive medicine if you have high blood pressure and others for coronary artery disease such as beta-blockers, nitrates, and statins. Keep a separate list of medications including dosing intervals and tablet size in the event that medications are lost. Among these medications, I want to stress that aspirin is very important in case you have chest pain or signs of stroke. If you have coronary artery disease (if you’ve had angioplasty or bypass surgery for example), sublingual nitroglycerin is a necessary medicine to include; should you have any signs of angina (chest pain), keep it in your carry-on luggage. Please also remember to adjust your dosing intervals to maintain proper frequency if crossing time zones. Carry a copy of your most recent ECG and a pacemaker card if you have a pacemaker.

Contact the airline concerning special needs, e.g. diet, medical oxygen, wheelchair, etc., and consider a special seat request, such as near the front or close to a restroom.

3. In-flight

Air travel is associated with an assortment of potential stressors on the physical and psychological wellbeing of travelers, and in-flight medical incidents during travel are common. While the average person is usually able to deal with fluctuations in cabin pressure without difficultly, people with cardiopulmonary conditions are more susceptible to changes in altitude are at an appreciably higher risk of developing symptoms of symptomatic hypoxia (oxygen deprivation).

Arrange for a wheelchair or electric cart for in-airport transportation. Assure adequate time between connections. Wear compression stockings, drink plenty of water, and try to stretch or complete in-flight exercises during long-distance flights. Should you need, anti-anxiety medication may also aid in preventing cardiopulmonary disease.

4. While traveling

When you choose your destination, consider the climate, geological conditions, and the temperature. Select a location you are interested in according to your abilities. If you’re elderly, I recommend river trips over mountain adventures; I had a patient who developed a heart attack while climbing the Great Wall—rescuers may find trouble evacuating you, which will cause delay in your treatment. Schedule a leisurely-paced trip, and don’t push yourself too hard. To avoid dehydration, drink water or a sports beverage often, especially if you’re in a hot climate or sweating.

Since extremes in temperature can trigger cardiac conditions (cold can trigger increases in blood pressure, and the sweating associated with hot weather can cause your blood to thicken, forming clots), I recommend traveling in the spring and autumn and avoiding winter and summer travel.

5. After your trip

Some people joke that they need a vacation after their vacation! You may find yourself very tired or exhausted after 1-2 weeks of excitement, and it’s very important to stabilize your emotions and routine. Get enough sleep, hydrate, eat lighter food, and avoid drinking too much alcohol, coffee, strong tea, or soda.

China is a very big country with stunning scenery and historical relics—a worthy trip for anyone to enjoy! For those interested in visiting China, should you need assistance, want to ask questions, or just want to stop by for a visit, we welcome you to seek our services at Beijing United Family Hospital and Clinics (BJU).