Screening Echocardiography of Military Aircrew Candidates: Aeromedical Implications

OBJECTIVES: Cardiovascular evaluation has a significant aspect in the medical screening process of aircrew candidates. Echocardiography may identify asymptomatic cardiac abnormalities which can jeopardize the aviator and flight safety, as well as conditions which may progress and disqualify a trained aviator. We assessed the value of adding routine echocardiography to the aeromedical screening process. METHODS: The study population consisted of 17- to 21-year-old healthy aircrew candidates. We retrospectively reviewed all routine echocardiographic studies performed during 1997-2008 at our clinic. Studies performed for a clinical indication were excluded. RESULTS: A total of 2,657 echocardiographic studies were analyzed. 2,506 were considered 'normal' (94.3%). 151 studies (5.7%) demonstrated findings which required further consideration and were considered 'abnormal'. Additional consideration included limitation to low-performance aircrafts (n = 22, 14.7%), prompt disqualification (n = 23, 15.3%), or further cardiovascular assessment (n = 106, 70% of 'abnormal' studies), which resulted in disqualification of 2 more candidates. Echocardiography resulted in disqualification of 0.94% of candidates, limitation to low-performance aircrafts in 0.83%, and need for follow-up in additional 1.54%. CONCLUSIONS: Echocardiographic screening affected aeromedical designation and follow-up decisions in 3.31% of candidates. Contribution of routine echocardiography is dependent on aeromedical policies. The Israeli Air Force policies regarding common findings are presented.