Three Cases of Pulmonary Thromboembolism After Air Travel

Pulmonary thromboembolism (PTE) after air travel, firstly reported by Symington in 1977, is also called “economy class syndrome.” We recently treated 3 such cases after patients took long-haul flights. All 3 were Japanese women arriving in Japan after 11.7 to 13.5 hours of flight in economy class. Their major symptoms were dyspnea, convulsion, and loss of consciousness. All had risk factors such as obesity, age greater than 40 years, and immobilization in a cramped seat. One took oral contraceptives and another had antiphospholipid syndrome. All 3 were immediately diagnosed with PTE, thanks to findings of ultrasonic echocardiography and computed tomography (CT). They were treated with heparin and immediately transferred to a university medical center. All were eventually discharged with no apparent adverse sequelae. The number of passengers who travel overseas is rapidly increasing. Although the occurrence of deep vein thrombosis and subsequent PTE is very rare, it is serious and may be life-threatening, so the possibility of its occurrence must be kept in mind.