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Fitness to fly for passengers with cardiovascular disease
  1. David Smith1,
  2. William Toff2,
  3. Michael Joy3,
  4. Nigel Dowdall4,
  5. Raymond Johnston5,
  6. Liz Clark6,
  7. Simon Gibbs7,
  8. Nick Boon8,
  9. David Hackett9,
  10. Chris Aps10,
  11. Mark Anderson11,
  12. John Cleland12
  1. 1Cardiac Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  2. 2Department of Cardiovascular Sciences, University of Leicester, Faculty Member of the NIHR Leicester Cardiovascular Biomedical Research Unit, Leicester, UK
  3. 3Postgraduate Medical School, Surrey University, UK
  4. 4British Airways, UK
  5. 5UK Civil Aviation Authority, UK
  6. 6Peninsula Heart and Stroke Network, Plymouth, UK
  7. 7National Heart and Lung Institute, Imperial College London and Department of Cardiology, Hammersmith Hospital, London, UK
  8. 8Past President, British Cardiovascular Society, London, UK
  9. 9British Cardiovascular Society, West Hertfordshire Hospitals NHS Trust, Hemel Hempstead General Hospital, UK
  10. 10Guy's and St Thomas' NHS Foundation Trust, London, UK
  11. 11The Cardiac Centre, Morriston Hospital, Swansea, UK
  12. 12Department of Cardiovascular and Respiratory Disease, University of Hull, Castle Hill Hospital, Hull, UK
  1. Correspondence to David Smith, Cardiac Department, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter EX2 5DW, UK; ldr.smith{at}

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Following this review of evidence and after due consideration, it is clear that there are few cardiovascular 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 intensive care units and carry extremely ill passengers.1

For those with cardiovascular disease who are not critically ill but who wish to fly on commercial aircraft, the aircraft environment does not pose a significant threat to their health. It is only when their underlying condition is associated with a significant risk of acute deterioration that reasonable restrictions should apply. For those at the more severe end of the spectrum of their specific cardiovascular condition, services exist to help make the journey more easily and safely. Most carriers and airport authorities provide assistance on the ground and in the air. Oxygen is available on most major carriers, although this is 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 to warn the carrier and/or airport authority of any requirements for assistance, including requirement for in-flight oxygen, well in advance of the date of departure. They are strongly advised to ensure they have an appropriate supply of their medication, a clear list of the medications and doses they take and a letter of 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 guidance herein.

The authors have contributed to this document in good faith and consider it to be an honest conclusion of the review of evidence and assessment of the …

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  • Provenance and peer review Not commissioned; externally peer reviewed.

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