Travel to high altitude with CAD

[VickyHK72]

I hope it’s ok to ask this here - I was diagnosed with coronary artery disease last year, I’m a 50 year old female with a strong family history (dad died at 57 from HA having had 3 prior heart attacks and a triple bypass 14 years prior to his final HA, grandad and uncle also died from HA in their 50’s) I have possible familial hypercholesterolaemia and my older sister has advanced heart disease.

I turned 50 this year and my dream is to go on holiday to the Galápagos Islands, however most of these holidays seem to start with a couple of days in Quito which has a relatively high altitude of 9350 feet and I’ve read this is not a good idea for anyone with heart disease. I’m reasonably fit having taken up running in the last 18 months and my CAD is mild, but I really don’t want to do anything stupid or take an unnecessary risk by going somewhere potentially risky to my heart health. Has anyone here got experience of high-ish altitudes and do you have any advice for me please? Prior to finding out about my CAD we went on holiday to Wyoming (around 5500 feet) and did have one short episode of feeling sick, light headed and a bit weird! Our hosts told me visitors often feel like this due to the altitude but with hindsight I wonder if it was linked to my CAD and this makes me more nervous about travelling somewhere even higher. Thankyou, Vicky

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Talk to your GP who will have access to your detailed medical records who will be able to offer a professional opinion regarding any risks to yourself. Alternatively talk to the BHF Heart Helpline nurse, We are all different and apart from not knowing all of your medical history the experiences of people on here may not necessarily be directly applicable to you.

[Chappychap]

I looked into this ahead of a trip to Mexico City (where the altitude is a little over 7,000 feet). I'm not medically qualified so you should check with your GP, but there are three things to be aware of,

1. If like many of us you take Bisoprolol then you're already at higher risk of fainting, a risk which increases with altitude. Just be aware, warn your travel companions, make sure you don't stand up too quickly, and always do some basic warm up exercises before exercising.

2. Altitude increases the risk of heart attacks. Which is part of the reason why ski insurance is especially expensive for heart patients. But in the scheme of things it's a fairly small increase, personally it's a gamble I'd take, but other, sensible thinking people, may decide differently.

3. Heart attacks used to have much higher fatality rates. That improved massively with quick access to hospitals that have stenting facilities. The hard fact is that without fast recourse to specialist treatment we're back to 1950's levels of heart attack survivability. I'm a yachtsman, sometimes going far off-shore, I also take cruising holidays where there's a ship's doctor on board but no stenting facilities, and I also take long haul flights where the plane may be mid ocean and several hours from help if the worst were to happen. I make a conscious choice, armed with all the facts, that these are risks I'm willing to take. I guess a trip to the Galapagos will involve similar isolation.

Life is full of risks. In my opinion it's about taking rational choices armed with all the facts. I try to steer a course between the two alternatives of wrapping myself in cotton wool while being frozen with anxiety, or kidding myself that bad things will never happen and living in denial and ignorance.

One final point. If you're in the UK then the one DNA test that you can access on the NHS is the FH gene tests. I'm not an expert but it sounds like you may qualify, if so "test don't guess", especially as there are some transformational new medications for people with a confirmed FH diagnosis.

Good luck!

[MichaelJH Heart Star]

Obviously run it past your GP/cardiologist first. There was some published research that suggested a maximum altitude of 2,500m for heart patients. This equates to Manchu Pinchu where occasionally people do get into trouble (my sister's friend did when they went) and Quito is somewhat over 3000m so definitely get advice. Why not try a short Swiss break at around 1,500m - 2,000m first. . Things to remember are listen to your body, avoid the heat of the day and keep well hydrated. Enjoy your holidays

[Dovaston]

Hi approximately 5 years ago I went to Chamonix Mont Blanc about 3,800 metres. Felt very unwell with chest tightness laboured breathing and Nausea. Managed to sit it out with GTN Spray until I got back to UK and ended up with Stents fitted. Certainly for me I would not venture above 4,000. Good luck with whatever you decide.🤔

[Mentdent]

I went to Galapagos via Quito a few years ago. Just make sure you take your aspirin before landing and don’t rush anywhere.The people in the group who didn’t had trouble with headaches.

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This paper discusses CAD and high altitudes at some length. The bottom line seems to be that few studies have been done on this topic, but there is good reason to be cautious:

ncbi.nlm.nih.gov/pmc/articl...

[KassieB]

Hi Vicky. I went on holiday to Ecuador and the Galápagos Islands in 2019. We stayed in Quito for four nights and also travelled to Cotopaxi which is slightly higher altitude. I really struggled with the altitude, out of breath and dizzy. Our bedroom was on the third floor with no lift. I couldn’t sleep at night gasping for air. This was totally unexpected and spoilt the beginning of our holiday. I was so relieved when we travelled to Guayaquil for our flight over to the islands and felt better instantly, the islands are amazing and we had a fabulous time. In 2021 I had a heart attack and a stent fitted, would I have gone to high altitude if I had known I had a heart problem? It’s not something I would ever do again. If you feel ok with travelling to a remote destination like Galapagos where there are very limited medical facilities maybe look at connecting to Guayaquil and not staying in Quito.

[Lonmayloon]

Hi VickyHK72, I have a family history of heart disease too. My father had triple CABG followed by valve replacement. I inherited his CAD, first suffering with angina in 2011. It was investigated very promptly and found to be caused by a severe blockage of the LAD and this was stented immediately. No further angina since then.

Also in 2011 we bought a house in the French alps and now split our time between Scotland at sea level and the alps at 4800 feet minimum. The highest resort in our valley is 7500 feet and the top of the ski area is at 10500 feet.

From my experience I notice slight breathlessness on exertion during the first day at altitude but I can acclimatise fairly quickly. Long hill walks are soon possible even at 7500 feet. At 10500 feet if any climbing is done the lack of oxygen is very noticeable but I have not had any other side effects.

I took up running two years ago and my better cardio fitness definitely helps at altitude. The local ski patrols confirm that every year people die of heart attacks on the slopes. This might be as a result of the victim going from a sedentary lifestyle for most of the year to intense activity during their skiing holiday (rather than the heart attack being caused by altitude).

[elliebath]

I now know that I have minor calcification ( but no surgery needed) but I too have strong family history. This diagnosis came about following my first angina experience. I was at altitude in the French Alps, not actually skiing but I went high in a ski lift and immediately couldn't breathe. I had to go straight back down to the village and it was several hours before I could breathe normally. On return to UK I saw my GP and sometime later a referral to cardio. Being unable to breathe is a frightening experience.