We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Air Travel–Related Deep Vein Thrombosis and Pulmonary Embolism FREE

Harvey J. Sugerman, MD; Bo G. Eklöf, MD; William D. Toff, MD; Alison E. Burke, MA; Edward H. Livingston, MD
JAMA. 2012;308(23):2531. doi:10.1001/jama.2012.4098.
Text Size: A A A
Published online

Deep vein thrombosis occurs when a blood clot forms in the deep veins of the leg and obstructs the flow of blood back to the heart. This can lead to swelling of the leg and pain in the calf muscle, although sometimes there are no symptoms. Pulmonary embolism occurs when blood clots leave the veins where they developed, travel through the right side of the heart, and lodge in the small or large branches of the blood vessels going to the lung (pulmonary arteries). This can cause symptoms such as chest pain, difficulty breathing, or coughing up blood. In severe cases, it may result in collapse and sudden death. Long airplane flights or multiple flights in a short period can be associated with deep vein thrombosis and pulmonary embolism. Any situation in which the leg is bent at the knee for prolonged periods without much active motion may lead to a reduction of blood flow and increase the risk of blood clots. Other factors can increase this risk, such as recent surgery, taking oral contraceptives or hormone therapy, pregnancy, cancer, heart problems, and older age. Inherited genetic factors may also play a role.


  • Properly fitted graduated compression stockings have been shown to be of some value.

  • For people at high risk, such as those who have had a previous episode of thrombosis, low-molecular-weight heparin can be prescribed by a primary care physician and can be self-administered by injection beneath the skin just prior to a flight.

  • Getting up frequently and walking in the aisle of the plane increases blood flow and may reduce the risk of clots forming but is not always practical or safe.

  • The simplest preventive measure is to frequently “pump your feet” while sitting in your seat. Alternately lifting the toes and then lifting the heels increases blood flow in the calf veins and reduces the risk of forming blood clots.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’ s website at www.jama.com. Many are available in English and Spanish. A Patient Page on thrombophlebitis was published in the April 6, 2011, issue of JAMA and one on pulmonary embolism in the January 11, 2006, issue.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.


This article was corrected for errors on March 8, 2013.



April 3, 2013
H. Nancy Sokol, MD
JAMA. 2013;309(13):1347. doi:10.1001/jama.2013.1337.
April 3, 2013
William D. Toff, MD; Harvey Sugerman, MD; Bo G. Eklöf, MD
JAMA. 2013;309(13):1347. doi:10.1001/jama.2013.1343.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Spanish Patient Page: Flebotrombosis profunda y embolia pulmonar relacionadas con los viajes aéreos.

Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Deep Vein Thrombosis

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Make the Diagnosis: Deep Vein Thrombosis