Fitness to fly for passengers with cardiovascular disease.

Following this review of evidence and after due consideration, it is clear that there are few conditions that warrant the denial of fitness to fly as a passenger. Given the right aircraft, on-board equipment and appropriately qualified and experienced escort personnel, aircraft can act as flying care units and carry extremely ill passengers.(1) For those with cardiovascular disease who are not critically ill but who wish to fly on aircraft, the aircraft environment does not pose a significant threat to their health. It is only when underlying condition is associated with a significant risk of acute deterioration that reasonable should apply. For those at the more severe end of the spectrum of their specific cardiovascular services exist to help make the journey more easily and safely. Most carriers and airport authorities assistance on the ground and in the air. Oxygen is available on most major carriers, although this sometimes subject to a charge and at least 7 days notice is normally required.(2) Passengers are advised to plan their arrival at the airport in plenty of time to avoid having to rush and warn the carrier and/or airport authority of any requirements for assistance, including requirement in-flight oxygen, well in advance of the date of departure. They are strongly advised to ensure they have appropriate supply of their medication, a clear list of the medications and doses they take and a letter explanation from their doctor regarding their condition, drugs, allergies and devices (eg, pacemaker). Physicians are advised to consider the stability of a passenger's condition and apply the herein. The authors have contributed to this document in good faith and consider it to be an honest conclusion the review of evidence and assessment of the risks. It is guidance only and responsibility for declaring a patient fit to travel rests with the attending physician. The airline carrier should always be informed if a sick passenger is intending to fly. It has a right to refuse carriage of a passenger at its own discretion, even if they technically fulfil these guidelines shown overleaf.