How should a person with cardiac problems prepare for travel by car, airplane or ship?

Travel is generally safe for people with heart disease - provided they stay within prescribed areas of activity, rest, medication and diet, according to Dr. Richard Levin, associate professor of medicine at New York University Medical Center.An estimated 17 percent to 20 percent of all Americans suffer from some form of cardiovascular disease, ranging from hypertension to atherosclerosis. And heart disease remains the leading cause of death of Americans both at home and traveling abroad. Determining the advisability of travel for people with heart disease should be made on an individual basis.

"If someone has had a heart attack and is not used to exercising, a trek through the mountains would not be recommended," Levin said.

In some instances a cardiac patient may be advised to postpone or curtail travel plans. "We would not advise air travel, for example, for someone who recently underwent heart surgery," Levin said.

As a plane ascends or descends, he explained, gases within body cavities expand and contract in response to changes in air pressure and may affect the healing of recent surgical wounds.

While traveling by car, especially if one is the driver, caution is appropriate for anyone with a history of heart disease. Studies have shown an increased incidence of physical and emotional stress in people with heart disease while driving.

Any sign of fatigue or anxiety is reason to take a break. If one is driving, plan to stop fairly frequently and stretch; if you remain fatigued, stay the night where you are rather than press on to your destination.

Levin said people with heart disease should find out before leaving on a trip how to prevent or treat such common travel-related ailments as jet lag, motion sickness and, particularly, traveler's diarrhea. The discomfort of the ailment and the dehydration that can result may put stress on the cardiovascular system and cause dangerously elevated pulse rates.

Standard preparations for anyone with a chronic medical condition also apply to people with heart ailments:

- A pre-trip physical examination and a physician's letter documenting the diagnosis and listing all required medications.

- A set of generic prescriptions for all needed medications, and enough medications to last the planned trip plus one week.

- A form of medical identification and travel health insurance

- And, if traveling abroad, a list of English-speaking doctors along the route.