By Joy Stephenson-Laws, JD, Founder

If you are a control freak, you are probably apprehensive each time you fly in an airplane. Because all you can really do is sit back, relax and let the pilot do his or her job until you reach your destination.

And overall, flying is pretty safe. You’re actually less likely to get in an accident on an airplane compared to riding in your car. There are also other random causes of death you are more likely to encounter than being a passenger on an airplane. For example, you are more likely to die from choking on food than you are from being a passenger on an airplane.

Check out these lifetime odds of death for selected causes per the National Safety Council:

• Passenger on an airplane, odds of dying are 1 in 188,364
• Motor vehicle crash, 1 in 103
• Choking on food, 1 in 2,696
• Sunstroke, 1 in 8,912
• Accidental gun discharge, 1 in 8,527
• Chronic lower respiratory disease, 1 in 27
• Cancer, 1 in 7
• Heart disease, 1 in 6

But medical emergencies can happen on airplanes, sometimes causing very unfortunate events. Take, for example, the recent passing of a 71-year-old woman who reportedly suffered from cardiac arrest on a United Airlines flight going from Germany to New Jersey.

According to the American Heart Association (AHA), cardiac arrest is “triggered by an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia).” This disrupts the pumping action of the heart and interferes with its ability to pump blood to critical organs, like the brain and lungs. If the victim of a cardiac arrest does not receive treatment, death occurs within minutes.

Many people confuse heart attacks with cardiac arrests but the two, while related, are different. A heart attack is a “circulation problem” and occurs when blood flow to the heart is blocked. “If the blocked artery is not reopened quickly, the part of the heart normally nourished by that artery begins to die,” reports the AHA.

So heart attacks may increase your risk for a cardiac arrest.

Attempts were made to save the woman who died on the United Airlines flight.

“Passengers aboard the plane say the cabin crew attempted to resuscitate the woman, administering oxygen and utilizing a defibrillator. Adam Lisberg, who spoke to the Sun, said ‘a number of people’ attempted to perform CPR for between 30 and 40 minutes,” according to this news report.

Despite their best efforts, unfortunately, she did not make it.

This tragic story got me thinking about whether people with heart disease may get enough oxygen on airplanes and how all this pertains to people with heart issues. We all know that before a flight takes off, flight attendants instruct you on how to use the oxygen masks in the event of an emergency with the plane. But how are oxygen levels different when you are just flying along in a plane? And what precautions do people with existing health issues such as heart disease need to take?

Afterall, you can live for weeks without food, days without water but only a few minutes without oxygen. Our cells use oxygen to help metabolize (burn) the nutrients released from the food we eat as well as for energy. And when you fly in an airplane, your supply of oxygen is somewhat decreased. This can be particularly taxing to people with heart issues.

“Because aircraft fly at higher altitudes, where oxygen levels are lower, the cabin of the plane is pressurized to the equivalent of approximately 8,000 feet above sea level. This altitude is typically tolerated well by healthy passengers, but cardiac patients may experience difficulty breathing, lightheadedness and chest pain,” according to one source.

A cardiologist referenced in this American Heart Association report said that high altitudes can make you more symptomatic if you have coronary artery disease because of the thin air and how oxygen is carried in your blood. According to the report, he compared it to a train that’s moving smaller loads and making more trips. “The engine — or in this case, your heart — has to work harder, especially if you already have blockage.”

There have been other tragic incidents of people dying on airplanes due to heart issues.

Back in 2015, a 57-year-old American Airlines pilot reportedly died mid-flight due to a heart attack.

(Airplane pilots are required to pass physical exams every 12 months, every six months if the pilot is 40 or over).

How can you be proactive?

• If you suffer from heart disease, it is imperative that you speak with a cardiologist or competent healthcare professional before you fly. If your doctor clears you for flying, he or she may recommend that you wear compression stockings, have access to additional oxygen (if you need oxygen, call your airline to find out its policies and the cost), closely monitor fluid intake and avoid drinking alcohol and other dehydrating beverages.
• Try to avoid blood clots. Wearing compression stockings can help prevent blood clots from forming in the legs, which could then travel to the heart. If you are on a long flight, it is also important to stand up and walk around when possible. This can significantly help prevent blood clots.
• “Sitting immobile on long plane flights can slightly increase a normal person’s risk of blood clots in the legs, but associated medical issues usually contribute to it. If someone has peripheral artery disease (PAD) also called vascular disease or a history of heart failure, the clot risk increases. Getting up and walking around when possible is recommended for long flights, just be sure the seatbelt light is not on when you do so,” says the American Heart Association. Also be aware of your nutrition. “To reduce risk of blood clots, it is important to consume foods that suppress platelet [tiny blood cells that help form clots] activation. Garlic, tomatoes and berries may help with anti-platelet activation,” according to this source.
• Stay hydrated & watch your fluids. When you’re on an airplane, the filtration systems zap humidity in the air (an aircraft usually has 10-20 percent humidity), making you more prone to dehydration. And being dehydrated may increase your risk of blood clots. So drink plenty of water, and it might be a good idea to avoid beverages with caffeine, like coffee, and alcohol which is also very dehydrating and depletes the body of essential nutrients such as potassium, which is a critical mineral for heart health. Harvard Health recommends drinking at least 8 ounces of water every hour or two. It might also be good to avoid salty foods. A doctor with the American Heart Association said to be mindful of your fluid consumption and sodium (salt) intake if you have cardiomyopathy or a history of heart failure. A balanced fluid intake is important with these conditions (especially when flying).
• If you are flying and have a heart condition, make sure the plane you are on has a defibrillator (a device that can help restore normal heartbeats). Not all planes have these devices. Call your airline in advance to see if they will have one available on your flight.
• Always have your medication accessible. Carry your meds on you or in your carry-on bag.

We may not be able to control what goes on in the air, but we can take proactive steps to try to prevent medical emergencies -- even if we suffer from heart conditions. 

(Check out our older blog here on other ways to stay healthy during long flights).

Enjoy your healthy life and safe travels!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.