• Steven Reinberg
• Posted September 10, 2021

Heading to the Mountains? Heart Patients Should Check With Their Doctor First

If the Alps or the Rockies are on your bucket list, check with your doctor first if you're at risk for cardiovascular disease.

New advice from the American Heart Association (AHA) suggests certain people take precautions before going to high altitude places.

These recommendations apply to folks with high blood pressure, coronary artery disease, heart rhythm abnormalities (arrhythmias) or heart failure.

In mountainous areas -- particularly heights of 9,800 to 16,400 feet above sea level -- activities such as skiing, hiking, bicycling or climbing can stress the heart and blood vessels because of lower levels of oxygen and changes in air pressure, temperature and humidity.

At high altitudes, the heart needs more oxygen-rich blood, even at rest. Fainting is common, even at altitudes of 8,800 feet above sea level and can happen within a day, according to the AHA statement.

"Many people and health care professionals are familiar with symptoms of acute mountain sickness like headaches, dizziness, nausea and weakness," said Dr. William Cornwell III, chair of the scientific statement writing group and an assistant professor of cardiology at the University of Colorado School of Medicine in Aurora.

"However, they may be less aware of the stress placed on the body -- and particularly the heart and lungs -- when people with cardiovascular disease travel to mountainous regions where there is a reduction in oxygen availability compared to sea-level conditions. If people are not prepared, they may be at an increased risk of adverse events in these types of environments," he said in an AHA news release.

"A thorough assessment by a health care professional may be necessary before a mountain sojourn to assess risk and ensure that people with a history of heart disease safely enjoy physical activities in the mountains," Cornwell advised.

He said would-be travelers should develop a plan with a health care professional, bearing in mind the location and duration of travel, along with the severity of the individual's medical conditions. The plan should address these key questions: Is the patient's heart condition stable and under control? What is the emergency plan if something goes wrong? Are there any additional medications needed in case of an emergency? Where is the closest hospital? Who should be called if you need to be evacuated from a remote location?

The statement defines low altitude as 1,640 to 6,560 feet above sea level and moderate altitude as 6,560 to 9,840 feet above sea level. High altitude is considered 9,840 to 16,400 feet, while extreme altitude is 16,400 feet or higher above sea level.

The AHA offers these tips for a safe trip to high altitudes:

• Gradually increase altitude so the body can adjust to lower levels of oxygen.
• Stay hydrated.
• Adjust medications based on medical advice. Ask your doctor if any additional medications are needed.
• Limit or avoid alcohol.
• Know the symptoms that should signal an emergency evacuation.
• Have emergency descent plans.

Sudden cardiac death is the most frequent non-traumatic cause of death at altitude. It may happen without warning and result in death. Risk factors include a history of heart attack, being male and older age.

Studies have found that more than 50% of sudden cardiac deaths at altitude happen on the first day. The risk may be reduced by one night sleeping above 3,381 feet, which gives the body time to acclimate to higher altitudes before engaging in physical activity.

The report was published online Sept. 9 in the Journal of the American Heart Association.

More information

For more on altitude and your heart, see the American College of Cardiology.

SOURCE: American Heart Association, news release, Sept. 9, 2021