Table 3

Cardiovascular investigations in aircrew 

Anatomical investigationsCardiac CT, cardiac MR or invasive coronary angiography, transthoracic and transoesophageal echocardiography
Physiological investigationsMyocardial perfusion imaging, including perfusion MRI, myocardial perfusion scintigraphy (MPS, both single photon emission CT (SPECT) and positron emission tomography (PET)), stress echocardiogram (with either physiological or pharmacological stress) and fractional flow reserve (FFR)
Clinical investigations (to further allow first line risk stratification)Exercise stress ECG test* (METS, symptoms), coronary artery calcium scoring
  • *Exercise stress ECG test is not recommended as a solely investigative tool for assessment of significant coronary artery disease in aircrew.10