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Francis V. Adams, M.D.
Francis V. Adams, M.D.

Economy Class Syndrome: Flight-Related DVT

What Is Deep Vein Thrombosis?
There is increasing evidence that sitting in airline seats for long flights puts people at risk for deep vein thrombosis (DVT). DVT, blood clots inside veins found deep in leg muscles or the pelvic area, is a common disorder. A venous thrombus, or clot, is a clump of blood cells, platelets, and fibrin, which attaches to the inside walls of veins, can grow in size, and break off to travel in the bloodstream.

If the blood clot stays where it is and continues to grow, it can cause swelling and irritation of the vein. If part of the clot breaks off, it may travel to the lungs (pulmonary embolus) and result in serious illness or even death. In some circumstances, deep vein thrombosis may also lead to other serious medical problems such as heart attack and stroke.

What Are the Symptoms of Deep Vein Thrombosis?
Deep venous thrombosis often does not cause any symptoms at all. Symptoms of DVT, if present, may include swelling of the involved leg with tenderness deep within the muscles of the leg. If the DVT occurs in veins in the pelvis there may be no symptoms.

Unfortunately, the first sign of DVT may be due to a complication, such as pulmonary embolus. Therefore, preventing DVT is key to stopping more serious disease and saving lives. Prevention is especially important since DVT during long flights may not allow for early medical intervention.

What Are the Risk Factors for DVT?
Generally, deep vein thrombosis is more common in women than men, and in people over age 40. The risk of DVT increases with age. Important risk factors include:

Flight-Related Risk Factors

  • Immobilization for long period of time
  • Cramped seating—hence the name economy class syndrome
  • Decreased oxygen
  • Decreased hydration

Medical-Related Risk Factors

  • Smoking
  • Obesity
  • Recent Trauma from an accident—especially to legs
  • Recent surgery—especially leg or pelvic surgery
  • Use of oral contraceptives or hormone replacement therapy
  • Previous DVT
  • History of malignancy
  • History of Inflammatory Bowel Disease—this disorder is especially associated with higher risk of DVT
  • Family history of DVT—especially in a relative under age 35

The risks are not simply additive—the chances of having DVT can more than double with 2 risk factors.

How Can I Prevent DVT?

During Travel

  • Stand up and walk around at least hourly
  • Exercise your calf muscles by going up on tiptoes several times while standing
  • Drink adequate fluids
  • Avoid alcohol as it increases the stickiness of platelets and promotes fluid loss
  • Avoid crossing legs or prolonged awkward hip or knee positions whenever seated
  • Wear loose fitting clothing when traveling

Other Things You Can Do

  • Stop Smoking
  • Lose Weight
  • Discuss with your doctor family and personal history that might pre-dispose you to DVT and increase your risk during travel
  • Discuss whether therapeutic compression stocking, and/or an anticoagulant would be helpful to you in preventing DVT
This article is based on information from NASA, the National Aeronautics and Space Administration.

Don’t let cramped conditions on an airplane put you at risk of DVT. Keep your body moving and take proper precautions to reduce the risk of "Economy Class Syndrome."

Download and print a sheet of simple exercises that you can do in your seat

Last modified on: 30 June 2015