The economy class syndrome - a survey of 19 cases

Background: Thromboembolic events during or immediately after long-distance flights (economy class syndrome - ECS) are gaining more importance due to the rapidly increasing number of flights. Systematic data on haemostatic pa rameters in these patients are not available yet. Patients and methods: We were therefore analyzing the anamnestic, laborator y and clinical findings in 19 patients (17 males, 2 females, aged 33-75 yea rs) with the final clinical diagnosis ECS. Results: Symptoms commenced either immediately or up to 93 hours after dise mbarkation (mean 42.3 hours). In the great majority (84.2%) myocardial infa rction was the initial diagnosis. No defect in the coagulation and/or prost aglandin system was discovered in either of the patients. Prevalence of smo king (26.3%) was even lower than in the normal population. No predisposing factors were found. Apparent anamnestic similarities were flu and fever (47 .4%) while 4 of the patients (26.3%) had severe diarrhoea and dehydration b efore the flight. Almost all the patients (78.9%) were drinking alcohol dur ing the flight and not actively moving their legs (84.2%). ECS occurred als o in business and first class passengers. Conclusion: Surprisingly the onset of ECS is definitely not associated with haemostatic defects and not necessarily associated with the clinical risk factors reported.