When Can a Pulmonary Embolism and Deep Vein Thrombosis Patient Fly Safely Again on Airplane? A Case Report

Special Issue - Atherosclerotic Vascular Disease

Austin J Clin Cardiolog. 2021; 7(2): 1079.

When Can a Pulmonary Embolism and Deep Vein Thrombosis Patient Fly Safely Again on Airplane? A Case Report

Lin S-L¹*, Lin W-C¹ and Hsu N-W²

¹Department of Internal Medicine, Division of Cardiology, Kaohsiung Yuan’s General Hospital, Kaohsiung City, Taiwan

²Department of Diagnostic Radiology, Kaohsiung Yuan’s General Hospital, Kaohsiung City, Taiwan

*Corresponding author: Shoa-Lin Lin, Department of Internal Medicine, Division of Cardiology, Yuan’s General Hospital, 162, Cheng-Kung First Road, Lingya District, Kaohsiung 80249, Taiwan

Received: June 11, 2021; Accepted: July 06, 2021; Published: July 13, 2021

Abstract

There was no recommendation in the current guidelines for how long after the pulmonary embolism (PE) attack the patient can fly again safely on an airplane. A 45 years old female was admitted to our hospital because of deep vein thrombosis and acute PE. Due to persistent leg swelling and afraid of recurrent PE for long distance flights, this patient received four weeks anticoagulant therapy before flying. Eventually, she flew back safely. This report describes our preliminary experience for managing this patient with deep vein thrombosis and PE.

Keywords: Acute pulmonary embolism; Anticoagulant; Computed tomography scan; Deep vein thrombosis

Introduction

Acute Pulmonary Embolism (PE) is a form of venous thromboembolism that is common and sometimes fatal [1,2]. We had a patient who developed deep vein thromboembolism and acute PE. Since this patient was a foreigner, after the initial treatment, she intended to go back to her country. Thus, the question arose regarding when a patient with acute PE and Deep Vein Thrombosis (DVT) can fly safely after the initial PE attack. Since there was no recommendation in the current European Society of Cardiology (ESC) [3] and American Society of Hematology (ASH) guidelines [4] for how long after PE attack the patient can fly safely, I have searched the query online. Diverse recommendations including waiting to fly on an airplane for at least four weeks [5] or even a few weeks to months after having DVT [6] were proposed. We herein report our preliminary experience with a patient who presented with DVT and acute PE.

Case Presentation

A 45 years-old female had traveled from Amsterdam to Taiwan for a vacation. On the 4th day after arrival in Taiwan, she had visited Taroko Mountain. She and her husband had to remain inside the hotel due to persistent raining for three days. Due to bad weather, she was almost entirely inactive in those three days. Afterwards, they travelled by train to Kaohsiung city for further holidays. Unfortunately, she developed leg swelling, chest tightness, tachycardia, and shortness of breath on the 1st day arriving in Kaohsiung city. She was sent to our Emergency Department (ED) for further management on October 16, 2017. At our ER, electrocardiogram showed normal sinus rhythm. Chest film showed borderline cardiomegaly but no active lung disease. Lab. data showed elevation of d-dimer (15.63mg/L). Chest Computed Tomography (CT) scan revealed filling defects in bilateral pulmonary arteries and interlobar pulmonary arteries (Figure 1). Under the impression of pulmonary embolism, she was admitted to our intensive care unit for further management on October 16, 2017.

Citation: Lin S-L, Lin W-C and Hsu N-W. When Can a Pulmonary Embolism and Deep Vein Thrombosis Patient Fly Safely Again on Airplane? A Case Report. Austin J Clin Cardiolog. 2021; 7(2): 1079.