Good morning everyone...Iam needing some advice about flying with an Aortic Root dilation and ascending...I just received a message from NHS England letting me know that my appointment with the cardiology consultant had been cancelled due to emergency 😢 actually the clinic has been cancelled for the 21st November 2024..My appointment is now February 6th 2025..The Lady who did my echo at the beginning of October said to me there has been a slight difference between the CT which was done October 2023. The measurements for the Arotic root in March was 40mm and the ascending 34mm. Measurements for the Arotic Root in October 41mm and the ascending 38mm..I what to ask my Cardiology consultant about flying as I have a holiday booked for Benidorm January 2025. Knowing I don't know the new measurements of the Arotic Root and ascending from the new echo which was done in the beginning of October...I have worried thoughts about flying and I can not get them out of my head, iam starting to get anxious daily and iam starting to have panic attacks while iam sleeping, it happened again last night, jumping out of bed and shouting out for help, it's happening to often now. Iam waiting for the talking therapist team from Durham to contact me but according to them over 20 week wait...I have spoken to the doctors all ready about if I have sleep apnea because I had large polyps removed from my nose in August this year. I only could breath though my mouth from July 2023 until August 2024...It was horrible, could not sleep properly eat food or drink..Lost 4 stone in weight because of it all..Anyways I would be really grateful for any advice about flying. Thankyou for Listening
Aortic root dilation and ascending - British Heart Fou...
Aortic root dilation and ascending
Jayjay,
Such a difficult situation we can find ourselves in! Hopefully I can put your mind at ease and indicate where you need to check on things.
Firstly, echo measurements of the aorta are not as accurate as CT measurements, so I wouldn't worry about the changes the echo lady mentioned. They would need confirming by an ECG-gated CT, which is the most accurate, where ECG-gating (firing the CT xrays at the same point in the heart's beating) freezes the motion for greater accuracy. Your consultant will decide how good he feels the echo results are and whether to get you another CT now or in a year or two's time.
A 4 mm increase in the ascending is quite likely (in my non-medical opinion) to be a result of measurement differences, especially as the root has not "grown" by more than 1 mm. There are as yet no standardised methods of exactly how you measure the aorta - it's not a straight piece of pipe, is very bendy and constantly moving as the heart pumps. In fact, the echosonographer was a little naughty mentioning anything to you. All results have to be reviewed by a doctor for accuracy/context etc.
Even the ascending figure of 38 mm by echo is not that large. The standard diameter used for deciding whether to intervene (surgery) is 50 mm (was 55 mm, but the 50 mm recognises that 55 was a bit large, plus that it's advisable to be seen in a main aortic centre where they do many such procedures a year, which is much safer).
The other things that are important are age, and you're still relatively young as aortas go. Also do you have any genetic conditions known to predispose to aortic problems, such as Marfan syndrome or other "connective tissue" disorders (CTDs)? And as well as known CTDs, have any of your relatives had any aortic issues - surgery or unexpected emergencies - as not all genetic conditions are yet identified? Any of these should be brought to your consultant's attention soon.
Finally, is your blood pressure under good control? The old ideal figure was 120/80 (or some say 140/90, but that's to avoid heart attacks etc.) Ideally you want to be below a resting BP of 110/75 when you have a dilated aorta.
As far as flying is concerned, I don't think a doctor would be concerned, unless your blood pressure was not well-controlled, and there's time to see your GP about that before you fly. I hope you will also get good travel insurance, and you do need to declare your medical conditions, but as the aorta is being monitored, they should accept it, with perhaps a slight premium increase. Mine was 46 mm and being monitored, and my insurers accepted me.
Whilst all the above is my own opinion and knowledge in good faith, I would still recommend asking your doctors. As your holiday is before your new consultant appointment, I suggest seeing your GP and asking if they will write to the consultant for an opinion. I have done this several times on certain questions.
Best wishes, and I hope this puts your mind at rest a bit.
Goodmorning Cliff_GThankyou for your fantastic advice and detailed post, people like you deserve much gratitude and grace for all the understanding you give and your welcome advice. Long waiting times to see a cardiology consultant on the NHS is on the up which puts people who has been diagnosed with some sort of heart issues gives much unwanted Anxiety situations which puts more pressure on the NHS. Don't get the wrong idea from what I have said so far..Iam much Greatfull and appreciated everything the NHS has done for me so far, if it wasn't for them treating everyone the best they can do, what would we do as a nation without them.Thanks again
I agree with CliffG again I have no medical knowledge My aortic root is 45 mm and the ascending aorta a bit less and has been stable for seven years. The measurements do vary a bit sometimes with echo s and the dilation tends to be larger when measured by MRI I have asked my cardiologist several times about flying and have never been told I cannot fly. I have had to get a fit to fly letter for the insurer on one occasion after I had an ablation for ectopic beats but the cardiologist was aware of my aortic root dilation. I have however been told I should not visit high altitudes (eg Peru or Ecuador) and that it is also important to keep blood pressure low if possible (am on blood pressure meds)best wishes and hope that you have a lovely holiday Lexi
Glad that I didn't read this a month ago as I've just got back from Peru and Ecuador!
Hi there, the thing is that you manage to get there and back without to much bother. At least you know now about the information which has been given so far. I found out that if you wanted to fly by air ambulance to Alicante return to Newcastle was £3000 which I thought which wasn't a bad price, you have your own team looking after you and the cabin pressure of there aircraft is 1500ft above sea level which is much low then any commercial flight
Hi Lexi thankyou for geting back to me with a fantastic post...In your post you have mentioned that you have been told that you should vist places with high altitudes, e.g Peru or Ecuador. .I have found out some interesting information..Ecuador city stands at altitude of 9350 ft above see leave. Correct. So if you take a flight somewhere in the world, cabin air pressure on an aircraft is like being 6000 to 8000 ft about sea level...This is why iam worried about flying because I do not know what kind of pressure is being put on the Arotic Root and ascending. The last time I took a fight was January this year to Benidorm with my family, after about 45mins into the flight started to get unwanted heart fluttering and heart rate keep on going up and going down until we touched down. It took afew days while in Benidorm for my heart rate to settle to around 70bpm. I wasn't looking forward at all for the return flight back to Newcastle. I was wondering if I was going to experience the same effects on the way home, which I did. The day we landed back in the UK, my heart rate keep on going up and down and eventually started to settle after afew days. I don't weather it was horrible Anxiety I was experiencing on the flight, but I was in tears because every time I started to feel heart fluttering I started crying, no one was really giving me any comfort or reassurance 😢 Iam going to Benidorm In January, so you can see why iam worried about going. Take care
Time to practice slow deep breathing! Both calms nerves and gets you blood pressure down.
While I now live in Ireland, I grew up in Colorado. We have a condo in Breckenridge (9600 ft). When I was first diagnosed with leaky valves my cardiologist recommended that I not travel to that kind of altitude anymore.
The next year, he asked if I went to Colorado anyway. I admitted that yes, I had. He shrugged and said "yeah, I would have ignored me too".
But you also have to ask yourself if the good parts of the vacation are worth the bad parts. If you sit in Benidorm the whole week worrying about the flight home, then perhaps not. I suffer from anxiety that is currently well-controlled with SSRIs and CBT. But there have been times where I have cancelled vacations because I knew I wasn't in good enough mental health at the time to enjoy them.
When you ask yourself this question, ignore any sunk costs. Let's say you've already spent £1,000 that you can't get back. The question at this point is not "have I wasted £1,000?", but rather "would I rather spend £1,000 potentially worrying in Benidorm, or would I rather spend £1,000 relatively happy at home?"
Just one final thought: the slow deep breathing really does work. It tricks your vagus nerve into lowering your heart rate and decreasing adrenal gland activity. (Laughing out loud supposedly work too, but I'm not sure how your fellow passengers would feel about that....)
Hi There, thankyou for you fantastic post...I understand exactly where you are coming from...To tell you the truth o have read to many stories about people taking ill and passing away mid flight, I have basically scared myself and over thinking things..when I start to get anxious I don't know how to carm myself down, I have tryed slow breathing many times but find it really difficult at times, is anything I could take before I actually take off.
Benzodiazepines are usually used for acute anxiety. You could ask your GP if they'd be appropriate in this case.
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