Hi everyone!
I had a question regarding flying with chest pain. I know that it is usually okay to fly with stable angina providing that it is well controlled with medications; however, does anyone know the ruling of flying with chest pain which isn’t/cannot be effectively always managed with medication?
Any experiences with flying with this type of angina would be much appreciated.
Thanks. Tos 
Before my angina was confirmed and I presented with chest pains end of 2016 my cardiologist told me he was advising I didn't take my booked and paid for trip to Australia!
One of the things that will cancel your travel insurance is travel against doctors advice, Luckily I had very good insurance and I successfully claimed.
If you booked and bought insurance before your pains and doctors visit you should be able to make a claim.
Whatever you do you really cannot now travel if you have been advised not to as you won't be covered for any health problems.
Hi Heather1957
Thanks for sharing your experience. Of course, my plan is not to travel against the cardiologists’ advice/orders. It was more to understand people’s experiences flying with chest pain.
Hello Tos92 I live with vasospastic angina which is resistant to treatment.
My diagnosis has been confirmed by an angiogram with acetylcholine.
I have frequent episodes of chest pain and end up in hospital once or twice a year for treatment with IV GTN and morphine to stabilise my unruly coronary vasospasms.
My Cardiologist, who is a Professor of Interventional Cardiology at well known London hospital, has given me permission to fly short haul only. No flights longer than 6 hours.
I use oxygen during the flight as the change in air pressure and the altitude can trigger my coronary vasospasms.
I use a portable oxygen concentrator on the flight. Otherwise you can book a seat with piped oxygen on the flight
Not all airplanes have piped oxygen available and you have to pay more to use piped oxygen.
The airline requires me to get a fit to fly letter from a doctor, stating that I well enough to fly, however I need oxygen throughout the flight and lists my medications.
I declare all of this to my travel insurers. I have to pay more for my insurance.
When I travel I use assisted travel, so I don't have to stand for long periods in a queue, which could trigger my vasospasms
I drink plenty of water during the flight. Do leg and ankle exercises to help prevent getting a deep vein thrombosis and wear compression socks.
I take my time and arrive at the airport early, I can't rush as the anxiety and stress could trigger my symptoms.
I rest once I arrive.
I travel with someone.
Heather has given you very important advice .
If you travel without the permission of your Cardiologist it will invalidate your travel insurance.
If your cardiologist has advised against the flight, that's your answer. Other people's experiences don't really come into it as both health conditions and insurance are so individual.
If you go against medical advice it will invalidate your insurance and if anything happens, things could become very expensive. Not to mention dangerous if it happens in the air.
I'm sorry if this response comes across as cold or blunt. I'm potentially facing something similar and the thought of losing my holiday is galling, so I'm not unsympathetic.
Hi Captain_Birdseye
Thanks for your input. I will not be travelling against the cardiologists’ advice, it is currently under review again so I’m waiting to see what the final decision is. It was more to understand people’s experiences of flying with chest pain as my angina doesn’t seem to respond to my current treatment.
I don't know how far you are traveling, but if practical is the train an alternative?
I appreciate if your flight is to Australia then the journey might be somewhat impractical not to mention VERY exciting!
Hi devonian186
I would’ve loved to take the train if it were an option; however, it’s a 7 hour direct flight and it wouldn’t be possible to take the train where I am planning to go.
Thanks for the suggestion.
Where's your spirit of adventure ?
You could spend many hours planning the route, train changes, time changes and hotels needed along the route and taken out a very large loan to pay for it.
Yes, all joking aside, it's not practical in your case and trying to book trains if changes are involved is much more complicated than point to point on a plane.
Some may say I have too much adventure just even considering to fly 🤣
I don’t think there’s a suitable railway network where I’m going even if taking trains was possible. I’m planning on going to the Middle East and they primarily use metros/trams within the country and do not have a primary railway network set up yet.
So, Arab Dhow it is then, with perhaps a few camels thrown in and then connect with the modern infrastructure..
That could be the alternative travel option, yes 🤣
Irrespective of what other people have experienced and whether your insurance will remain valid or not etc etc , your cardiologist has recommended you don't fly. What new medical evidence is there for him/her to change their decision? And is your flight journey worth the risk you are placing yourself under given this advice? Life is full of risks and we should do our best to mitigate or avoid them wherever practicable. In your case the disappointment and perhaps financial loss may nevertheless outweigh the risk of travelling. So please consider carefully particularly since your own life may be at stake.
My cardiologist has ordered another test to be conducted before I fly, hence he will re-review based on those results/ new medical evidence.
As stated on some of the responses above, I will not fly against the cardiologists’ instructions if the decision remains the same. However, if the decision is changed, and I am allowed to fly based on this new evidence, then I would like to think other people’s experiences with flying could give me some insight.
Thanks for your input Hidden .
Tos92 Here are the guidelines from the Civil Aviation Authority.
You have indicated that you also have a myocardial bridge and experienced a Myocardial Infarction non obstructive coronary arteries MINOCA, thought to be caused by a coronary vasospasm.
You previously flew back after your heart attack from abroad.
Did you obtain medical clearance before you flew?
Did you inform your travel insurance company ?
What test is your Cardiologist offering to ensure it is safe for you to fly?
It's very late in the day to arrange any testing, get the results and have a confirmation in writing that you are fit to fly.
Have you discussed your situation with your travel insurance company?
One final consideration, how would you manage a severe prolonged episode of coronary vasospasms during the 7 hour flight?
How would the cabin crew respond?
Your flight might have to be diverted.
caa.co.uk/passengers/before...
Milkfairy answers to your questions below:
Yes, I obtained only verbal medical clearance from the cardiologist treating me at the time before flying back to the U.K.
Yes, my travel insurance company were informed about the entire situation.
A myocardial perfusion scan is being arranged to re-assess the presence of ischaemia to the heart due to the persistent chest pain which I experience.
The testing isn’t scheduled until next week, and my flight is not due yet so I have some time to have the test conducted and the results reviewed as per the cardiologists’ recommendation.
Yes, my travel insurance company are up-to-date with my current medical conditions and I have cover in place to protect me should anything happen abroad.
Managing a prolonged vasospasm would require my cardiologist and I to come up with a plan. I assume medications to treat the pain, and perhaps he will suggest supplemental oxygen which is provided by the airline I intend on travelling with should it be deemed necessary. I suppose this will be made clearer once I get the results of my next test.
I intend to make the cabin crew aware of my medical condition before flying so that they are aware that I may be in need of assistance.
As I have mentioned above, if the decision is to not fly despite completing the tests recommended by the cardiologist, then I will not fly.
Thanks for attaching the CAA guidelines.
Some airlines only have limited piped oxygen which you need to pre book. You can take an approved oxygen concentrator on board the flight which I do.
I had to send in my fit to fly letter and details of my oxygen concentrator 2 weeks before flying to the airline.
Vasospastic angina is unlike other types of angina. It's a transient constriction of the blood vessels. It comes and goes.
All the tests for myocardial ischaemia can be normal.
A myocardial perfusion scan isn't going to be able to say whether you'll experience a coronary vasospasm during the flight.
The physiological affects of flying on the body such as raising your heart rate can trigger a coronary vasospasm.
The problem is if you experience a prolonged coronary vasospasm during the flight which doesn't respond to GTN spray.
Some countries require written approval to allow you to take a pain relieving medications such as codiene into the country.
It's good to see you have travel insurance in place. Do check the small print!
Insurance companies don't have a great reputation for paying out in all circumstances.
10 days after my admission to hospital last May, I flew to Portugal. It was written in my discharge notes that the Consultant Cardiologist on call had said I was fit to fly.
I hope you are travelling with someone, the physical effort and stress of the flight can be very tiring.
That's why it's so important to rest the day after travelling.
I hope you can find a way to travel safely and then enjoy your time abroad.
I don’t think at this point, I will be requiring oxygen as the cardiologist hasn’t mentioned this yet.
I have previously, and still do actually, have a high heart rate from time to time so I understand that this could potentially trigger a spasm.
In terms of the myocardial perfusion scan, this was what he suggested and would be most comfortable with before giving me the all clear to fly.
I don’t think any test could possibly determine whether I would, or would not spasm whilst flying.
I have already checked medication requirements for the country that I am flying to. Thankfully, my medications don’t need to be approved; however, I will take my doctors letters regarding my medication use anyway.
I have read, and re-read the small print on my travel insurance so I think I should be okay as far as that goes. I appreciate not all travel insurance companies are willing to pay out but I have successfully claimed back before, although it took 6 months to get the payments reimbursed.
If approved to travel, then I will be travelling with my best friend.
Thanks for all the tips Milkfairy !
Noted :).
Oh goodness I wouldn't travel anywhere with chest pain,goodness knows what your insurance would be.
Hi ETHEL103
Thanks for your advice and concern. I’ve been able to get a good quote from Staysure and my travel insurance has always been with them. I thought it would cost an arm and a leg but surprisingly not.
I appreciate the concern in terms of travelling with chest pain and I am aware of the risks with it; however, I am somewhat resistant to treatment so I don’t imagine the chest pain going away any time soon as I’ve had this pain for years and there doesn’t seem to be a solution for it medically so far.
Hi, I have suffered from angina for many years during which I flew several times, though not in the last 5 years, with the GPs written permission and insurance cover. I found that pressure changes on take off and especially landing set it off. I then instigated a regime of using my gtn spay just before take off and again before descent. It worked for me. If you get permission to fly you could discuss with your cardiologist/ GP to see if it might work and be safe for you. Good luck in your endeavors.
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