You review a 60-year-old man who was diagnosed with stable angina two months ago. His angina is currently well controlled, but he has run out of his GTN spray and is requesting an emergency prescription. His angina has not changed recently and remains stable. He has a commercial flight booked to the United States tomorrow.
Yes – he can fly with stable angina as it is not a contraindication to commercial flight. Unstable angina, however, is a contraindication.
2. Give two cardiovascular conditions, other than any form of angina, that are considered contraindications to commercial flight by the Civil Aviation Authority.
According to the Civil Aviation Authority, the following are considered cardiovascular contraindications to commercial airline flight:
- Uncomplicated MI within 7 days
- Complicated MI within 4-6 weeks
- Unstable angina
- Decompensated congestive heart failure
- Uncontrolled hypertension
- CABG within 10 days
- CVA within 3 days
- Uncontrolled cardiac arrhythmia
- Severe symptomatic valvular heart disease
If the haemoglobin concentration is less than 7.5 g/dl, a special assessment should be made, and the use of supplemental oxygen should be considered.
The following are considered cardiovascular indications for the use of supplemental oxygen during commercial airline flights:
- Use of oxygen at baseline altitude
- Angina Canadian Cardiovascular Society (CCS) class III or IV
- Congestive Heart Failure New York Heart Association (NYHA) Class III or IV
- Cyanotic congenital heart disease
- Primary pulmonary hypertension