heart disease and fitness to fly

Last edited 08/2019 and last reviewed 08/2019

Cardiovascular indications for medical oxygen during commercial airline flights

Use of oxygen at baseline altitude
  • CHF NYHA class III - IV or baseline PaO2 less than 70 mm Hg

  • Angina CCS class III-IV

  • Cyanotic congenital heart disease

  • Primary pulmonary hypertension

  • Other cardiovascular diseases associated with known baseline hypoxemia

CHF - Congestive Heart Failure

NYHA - York Heart Association

CCS - Canadian Cardiovascular Society

For those with cerebral arterial insufficiency, supplementary oxygen may be advisable to prevent hypoxia. Clinical judgement has an important role in the individual assessment of fitness to fly. However, some cardiovascular contraindications to flight are shown in Table below:

Cardiovascular contraindications to commercial airline flight (1)


  • Uncomplicated myocardial infarction within 7 days

  • Complicated myocardial infarction within 4-6 weeks

  • Unstable angina

  • Decompensated congestive heart failure

  • Uncontrolled hypertension

  • CABG within 10 days CVA within 3 days

  • Uncontrolled cardiac arrhythmia

  • Severe symptomatic valvular heart disease

Also (2):

  • Pacemaker or defibrillator implantation
    • accept as fit to fly if >=2 days since procedure if no pneumothorax and rhythm is stable. In the event of a pneumothorax, flying should be deferred for 2 weeks following complete resolution

  • Ablation therapy
    • accept as fit to fly if >= 2 days since procedure
    • note that patient flying within a week of the procedure is considered at high risk of DVT

  • deep vein thrombosis
    • fit to fly if asymptomatic and stable on anticoagulant therapy

For up to date advice then check current guidance (1,2).

See linked items below for more details.

Note that these are only guidelines and each airline has its own regulations and medical standards.