Experts call it “economy class syndrome” – but it can happen to anyone in any class on the plane.
Deep vein thrombosis (DVT) occurs when blood clots in one or more veins.
Dr Pinakin V. Parekh, consultant cardiologist at Harley Street Heart and Vascular Center in Singapore, said this can happen at any time, but people traveling on long-haul flights are at a higher risk , because they sit for long periods of time.
“Theoretically, people traveling in better cabins — business class, first class — have more room to move around and stretch their legs,” he told CNBC Travel. “So it’s all about space on the plane.”
But Parikh is quick to point out that so-called “economy class syndrome” does not discriminate based on where you sit or how often travelers fly, he said.
“I’ve had patients develop DVT even when they traveled business class,” he said. Plus, “If you decide not to move, this may be the only flight you ever take.”
What increases risk
Deep vein thrombosis usually forms in the legs. Symptoms include pain, swelling, skin color changes and a feeling of warmth, but some people show no signs at all, according to the Mayo Clinic.
People who are obese, over age 60, take birth control pills or hormone replacement therapy, or smoke are at higher risk for deep vein thrombosis, the medical center said.
But flying comes with its own risks, he said Parekh.
“One in every 5,000 flights… may develop deep vein thrombosis (DVT) simply due to the risks of air travel,” he said.
A 52-year-old former banking businessman said he suffered a deep vein thrombosis during a four-hour flight from Singapore to Hong Kong.
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He said those taking long-haul flights were at greater risk, but deep vein thrombosis could occur on short-haul flights.
“People used to define long-haul flights as eight hours,” he said, “but there’s some data that suggests even four hours is now considered long enough.”
Parekh’s patient, Alok Tapadia, said he developed deep vein thrombosis during a four-hour flight from Singapore to Hong Kong.
Tapadia was Parekh’s patient.
He said he played badminton three times a week, so he knew something was wrong when he felt out of breath while walking up the stairs after arriving in Hong Kong.
“One of the escalators stopped working,” Tapadia said, so he walked up the stairs. “I had to stop for a moment and I wondered what was happening to me.”
It wasn’t until he returned to Singapore that he was still out of breath and his heart rate was elevated, so he went for a check-up.
He said doctors told him a blood clot had entered the pulmonary artery, which connects the heart to the lungs.
This kind of plot will really shock you.
He said his first scan showed an enlarged heart, which occurs when the heart beats too hard. He said that immediately after the second scan, Tapadia was admitted to the hospital’s intensive care unit.
He said doctors found he was “severely” hypoxic and his lungs were completely blocked.
Thapadia said doctors said the situation was “critical because the heart is under too much pressure and could stop or enter a more critical stage at any time.”
Blood thinners don’t dissolve clots fast enough, he said.
So his doctors ended up doing a cardiac catheterization, which involves threading a catheter through a blood vessel near the heart to dissolve the clot from the inside, Thapadia said.
Tips for reducing DVT
DVT can develop into pulmonary embolism, a potentially life-threatening complication that occurs when a blood clot breaks off and becomes lodged in a blood vessel in the lungs, according to the Mayo Clinic.
Parikh said when blood clots travel to the lungs, symptoms such as difficulty breathing and chest pain may occur.
There’s no way to completely eliminate the risk of deep vein thrombosis, Parikh said. But he said there are ways to reduce risks when flying.
The Mayo Clinic recommends drinking plenty of fluids, standing and walking around on the plane during the flight, rolling your ankles when sitting, and wearing supportive stockings.
Parekh has a simple tip for passengers: Choose an aisle seat.
It “encourages you to step up and start walking more easily because when you’re always in the line you’re always worried about disturbing that person [next to you],” Parekh said.
Tapadia said that after more than a year, he returned to his normal lifestyle, including traveling and playing badminton, but said he changed some travel habits starting at the airport.
He said he now walks through the airport instead of taking the moving walkways. Plus, he said, he walks up and down the aisles while flying.
He advised travelers to pay attention to their health and any warning signs.
“An episode like this will really shock you,” he said.
