Suspected coronary artery disease among military aviation personnel
Buckendorf, W.; Warren, S.E.; Vieweg, W.V.
Aviation Space and Environmental Medicine 51(10): 1153-1158
1980
ISSN/ISBN: 0095-6562 PMID: 7469961 Document Number: 162299
From 1971-80, 127 military aviation personnel underwent a complete cardiovascular evaluation for possible ischemic heart disease. In a retrospective analysis these individuals were divided into 4 groups: I, asymptomatic; II, atypical chest pain; III, angina pectoris; and IV, status post-myocardial infarction. Records were scrutinized for coronary artery disease risk factors, results of exercise stress testing, findings at selective coronary angiography and disposition. While all groups were of comparable age, risk factors for ischemic heart disease were found most frequently in groups III and IV. A positive exercise stress test was of greatest value in groups III and IV, while a negative test was chiefly of value in groups I and II. All patients underwent cardiac catheterization, which revealed high-grade obstructive coronary artery disease in 4, 17, 50 and 81% of groups I through IV, respectively. Following myocardial infarction a diagnosis of coronary artery disease or bypass surgery, 9 of 47 Naval flight personnel returned to flight status; of these, 2 suffered myocardial infarctions within 4 yr of follow-up, and 1 died. There is a low incidence of significant obstructive coronary artery disease in young aviation personnel presenting without symptoms or with atypical chest pain; the converse is true of patients with a history of angina or myocardial infarction. Aggressive attempts to rule out the diagnosis of coronary artery disease seem justified in suspect personnel. Those individuals rehabilitated after a diagnosis of ischemic heart disease remain at risk for subsequent acute coronary insufficiency. The feasibility of returning such individuals to full flight status must ultimately be determined by additional prospective studies.