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Heart muscle disease management in aircrew
  1. Joanna L D’Arcy1,
  2. Olivier Manen2,
  3. Eddie D Davenport3,
  4. Thomas Syburra4,
  5. Rienk Rienks5,
  6. Norbert Guettler6,
  7. Dennis Bron7,
  8. Gary Gray8,
  9. Edward D Nicol1
  1. 1 Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, Oxfordshire, UK
  2. 2 Aviation Medicine Department, AeMC, Percy Military Hospital, Clamart, Île-de-France, France
  3. 3 Aeromedical Consult Service, United States Air Force School of Aerospace Medicine, Wright-Patterson AFB, Ohio, USA
  4. 4 Cardiac Surgery Department, Luzerner Kantonsspital, Luzern, Switzerland
  5. 5 Department of Cardiology, University Medical Center Utrecht and Central Military Hospital, Utrecht, The Netherlands
  6. 6 German Air Force Center for Aerospace Medicine, Fuerstenfeldbruck, Germany
  7. 7 Aeromedical Centre, Swiss Air Force, Duebendorf, Switzerland
  8. 8 Canadian Forces Environmental Medical Establishment, Toronto, Ontario, Canada
  1. Correspondence to Dr Edward D Nicol, Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire SG16 6DN, UK; e.nicol{at}


This manuscript focuses on the broad aviation medicine considerations that are required to optimally manage aircrew with suspected or confirmed heart muscle disease (both pilots and non-pilot aviation professionals). ECG abnormalities on aircrew periodic medical examination or presentation of a family member with a confirmed cardiomyopathy are the most common reason for investigation of heart muscle disease in aircrew. Holter monitoring and imaging, including cardiac MRI is recommended to confirm or exclude the presence of heart muscle disease and, if confirmed, management should be led by a subspecialist. Confirmed heart muscle disease often requires restriction toflying duties due to concerns regarding arrhythmia. Pericarditis and myocarditis usually require temporary restriction and return to flying duties is usually dependent on a lack of recurrent symptoms and acceptable imaging and electrophysiological investigations.

  • heart disease
  • myocardial disease
  • health care delivery

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  • Contributors All authors are members of the NATO Occupational Aviation Cardiology Working Group.

  • Funding Produced with support from NATO CSO and HFM-251 Partner Nations.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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