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Return to flying after coronary artery disease: A case series among Malaysian pilots

OBJECTIVES: Pilots with coronary artery disease (CAD) are at increased risk of myocardial infarction, stroke, and possibly death. Return to flying duties may be considered after a detailed risk assessment. The aim of this retrospective case series is to describe the return to flying duty process. ME...

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Autores principales: Mohammad, Zulkefley, Ismail, Rosnah, Mohamed Rus, Mohd Rafizi, Haron, Mohammed Haizar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217071/
https://www.ncbi.nlm.nih.gov/pubmed/34155722
http://dx.doi.org/10.1002/1348-9585.12241
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author Mohammad, Zulkefley
Ismail, Rosnah
Mohamed Rus, Mohd Rafizi
Haron, Mohammed Haizar
author_facet Mohammad, Zulkefley
Ismail, Rosnah
Mohamed Rus, Mohd Rafizi
Haron, Mohammed Haizar
author_sort Mohammad, Zulkefley
collection PubMed
description OBJECTIVES: Pilots with coronary artery disease (CAD) are at increased risk of myocardial infarction, stroke, and possibly death. Return to flying duties may be considered after a detailed risk assessment. The aim of this retrospective case series is to describe the return to flying duty process. METHODS: We conducted a retrospective case review of pilots diagnosed with CAD at the Institute of Aviation Medicine (IAM), Royal Malaysian Air Force (RMAF) in October 2020. RESULTS: Thirteen cases of CAD were included in the review. Ten pilots were diagnosed after developing acute coronary syndrome; the remaining three pilots were diagnosed during a routine medical examination via an exercise stress test. Twelve pilots required a revascularization procedure. A total of 11 pilots (84.6%) were recertified for flying duties, while another two were disqualified. The duration to recertification for these 11 pilots was between three months and one year. CONCLUSIONS: The risk assessment was initiated with initial risk‐stratification using population‐appropriate risk calculator combined with the 4 × 4 aeromedical risk matrix. The reassessment of return to flying after coronary artery disease must be carried out no sooner than six months after the event. Pilots must be hemodynamically stable with no evidence of significant inducible ischemic left and a minimum 50% of ventricular ejection fraction (LVEF). A follow‐up is recommended at the initial six months after recertification and then annually with a routine noninvasive cardiac assessment.
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spelling pubmed-82170712021-06-28 Return to flying after coronary artery disease: A case series among Malaysian pilots Mohammad, Zulkefley Ismail, Rosnah Mohamed Rus, Mohd Rafizi Haron, Mohammed Haizar J Occup Health Case Study OBJECTIVES: Pilots with coronary artery disease (CAD) are at increased risk of myocardial infarction, stroke, and possibly death. Return to flying duties may be considered after a detailed risk assessment. The aim of this retrospective case series is to describe the return to flying duty process. METHODS: We conducted a retrospective case review of pilots diagnosed with CAD at the Institute of Aviation Medicine (IAM), Royal Malaysian Air Force (RMAF) in October 2020. RESULTS: Thirteen cases of CAD were included in the review. Ten pilots were diagnosed after developing acute coronary syndrome; the remaining three pilots were diagnosed during a routine medical examination via an exercise stress test. Twelve pilots required a revascularization procedure. A total of 11 pilots (84.6%) were recertified for flying duties, while another two were disqualified. The duration to recertification for these 11 pilots was between three months and one year. CONCLUSIONS: The risk assessment was initiated with initial risk‐stratification using population‐appropriate risk calculator combined with the 4 × 4 aeromedical risk matrix. The reassessment of return to flying after coronary artery disease must be carried out no sooner than six months after the event. Pilots must be hemodynamically stable with no evidence of significant inducible ischemic left and a minimum 50% of ventricular ejection fraction (LVEF). A follow‐up is recommended at the initial six months after recertification and then annually with a routine noninvasive cardiac assessment. John Wiley and Sons Inc. 2021-06-21 /pmc/articles/PMC8217071/ /pubmed/34155722 http://dx.doi.org/10.1002/1348-9585.12241 Text en © 2021 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Study
Mohammad, Zulkefley
Ismail, Rosnah
Mohamed Rus, Mohd Rafizi
Haron, Mohammed Haizar
Return to flying after coronary artery disease: A case series among Malaysian pilots
title Return to flying after coronary artery disease: A case series among Malaysian pilots
title_full Return to flying after coronary artery disease: A case series among Malaysian pilots
title_fullStr Return to flying after coronary artery disease: A case series among Malaysian pilots
title_full_unstemmed Return to flying after coronary artery disease: A case series among Malaysian pilots
title_short Return to flying after coronary artery disease: A case series among Malaysian pilots
title_sort return to flying after coronary artery disease: a case series among malaysian pilots
topic Case Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217071/
https://www.ncbi.nlm.nih.gov/pubmed/34155722
http://dx.doi.org/10.1002/1348-9585.12241
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