Economy Class Syndrome

What is economy class syndrome?

Definition

Economy Class Syndrome refers to deep vein thrombosis. This condition results from decreased blood flow or poor blood circulation; blood clots can appear when circulation to low limbs is abnormally sluggish.

Developing deep vein thrombosis after long plane journeys is often called "economy-class syndrome" or "coach-class syndrome," due to the fact that seating and leg room are particularly cramped for passengers in economy class.

Remaining immobile for several hours and not being able to stretch your legs slows circulation, which increases the risk of blood clots. Other factors - such as low cabin pressure, low humidity and dehydration - may aggravate this risk.

In fact, being seated for a long time always heightens the risk of thrombosis; this condition does not only affect people travelling by plane, but also those travelling by train, bus or car on long trips.

Symptoms

There are two signs of blood clots: the person has a sudden swelling in the leg, as well as cramping or tenderness, generally in the calf. Bruises or swelling may also appear behind the knee.

Symptoms are not always visible, and one out of two cases shows no symptoms at all.

The risk of deep vein thrombosis is aggravated by remaining seated with legs crossed, exposure to excessive heat, tobacco smoking, alcohol consumption, dehydration, excessive weight or oral contraceptive treatments.

What is the risk?

Thrombosis is always serious: it is vital to act as soon as possible to avoid further complications.

Thrombosis can degenerate into pulmonary embolism; if the clot frees itself from the vein, travels through the bloodstream and ends up in the pulmonary artery, it can obstruct a vessel in the lungs, restricting blood flow, and thus provoking a pulmonary embolism.

The person will then complain of sharp chest pain and loss of breath. Symptoms may also include coughing, spitting blood, fever and tachycardia. Embolism causes a major cardiac malfunction which can lead to stroke, and even death.

If you think you might be suffering from thrombosis, you must seek medical advice without delay.

What prevention measures to take

In-flight Exercises

Stand up and take a few steps around the cabin as often as possible (ideally, 5 minutes every two hours).

You can also do some exercises to activate blood circulation: if possible, extend your legs and alternately flex your feet, spreading and then pointing the toes.

If your shoes limit toe movement, just make an effort to move your feet and ankles, or remove your shoes.

You can also rotate your ankles, making circles in the air with your toes. If there is not enough room to extend your legs, keep your feet flat on the floor and push down curling your toes while lifting your heels from the floor. Then, lift and spread your toes with your heels flat on the floor.

Exercise your thigh muscles by sitting with your feet flat on the floor, and sliding your feet forward a few inches. Then slide back and repeat the exercise.

Wear loose clothing (your pants and socks should not be too tight), avoid wearing belts, tight pants, girdles and small or tight shoes, as your feet might swell during the trip.

Hydration

To ensure proper hydration, you have to drink one litre of liquid every 4 or 5 hours.

Avoid drinking alcohol, coffee or diuretic drinks.

Preventive Medecine

Corrective surgery for cardiovascular deficiencies must be performed at least two months before travelling to be effective.

Seek advice from your physician before using any medication.

Airlines may advise you to take cardiovascular drugs 24 hours before departure.

Antecedents

People with cardiovascular diseases or individuals at risk for blood clots in their legs may be given a single dose of heparin. This drug prevents clots from forming and is effective in reducing the risk of deep vein thrombosis in high-risk patients.

People with cardiovascular deficiencies or varix should wear compression stockings in order to avoid the sensation of heavy legs and swelling.

It is recommended to take your usual cardiovascular drugs.

Upon Arrival

Upon arrival, take a lukewarm shower and have a rest with your legs slightly raised; you should recover quickly.