Heart attacks afflict more than 1.2 million people each year, and though nearly 40 percent of people die from them, increasing numbers of people are living long and active lives after heart attacks. Concern about air travel has long gone hand in hand with recovery from heart attack. Metal detectors and x-rays that disrupt pacemakers, cabins pressurized at high altitudes, and the difficulty of getting medical attention quickly has deterred some recent heart attack survivors from flying. However, the number of heart attacks that occur on airplanes each year is actually quite low and, as cardiologists from the Yale School of Medicine conclude in a recent study, most survivors are clear for takeoff.

What the cardiologists wanted to know: Is it safe for people who have had a heart attack to fly and what precautions should these patients take?

What they did: The doctors compiled previous research on specific risks and complications of heart attacks and air travel. They analyzed the results of dozens of studies to come up with recommendations for doctors and their patients who are thinking about traveling by air. One of the studies they looked at even had people with pacemakers stand in airport security gates for at least 20 seconds to see if it caused a disruption.

What they found: Studies have found that the airport security gates didn't cause a problem, nor did many other aspects of air travel. For patients who had heart attacks at least three weeks prior to air travel and had recovered without complications, or for those who had been stable for at least three weeks, the authors said that air travel is fairly safe. Several medical groups, including the American Medical Association and American Heart Association, have adopted similar guidelines for travelers with heart problems. The authors warned that patients who have had open-heart surgery have to be more careful but, barring complications, they could also travel after three weeks. Also, some patients require additional oxygen after heart attacks—those people will certainly need it while flying because of cabin pressure and should consult their airline about how to get it during the flight. Blood clots which can cut off circulation to organs or even cause another heart attack have been a concern for travelers; the authors found that flights longer than eight hours increased risk of clotting, but heart attacks did not significantly affect risk.

What it means to you: Always consult your doctor before flying if you have had a heart attack and especially if you have recently had a heart attack. But the good news is that it's likely you'll be able to fly without a problem.

Caveats: This article centered around the fictional case of a 65-year-old man who had a heart attack a year ago and had experienced typical symptoms since. So, it did not address the risk of flying for specific groups of people, such as adolescents, women, or children, or those with complications from surgery or the heart attack.

Find out more: The Aerospace Medical Association has a 22-page book available free online called Medical Guidelines for Airline Travel that is intended for doctors but, if you can wade through the medical jargon, has a lot of information. Download it at http://www.asma.org/.

The American Heart Association has information about many of the side effects and symptoms of heart disease, especially if you click on the "Heart and Stroke Encyclopedia."

Read the article: Possick, S. and Barry, M. "Evaluation and Management of the Cardiovascular Patient Embarking on Air Travel." Annals of Internal Medicine. July 20, 2004, Vol. 141, No.2, pp. 148-154.