Prevalence of cardiovascular abnormalities in pilots involved in fatal general aviation airplane accidents

INTRODUCTION: Cardiovascular disease in general and coronary heart disease in particular remains the leading cause of morbidity and mortality in developed countries. Coronary artery disease is of concern in aviation because of its potential to cause sudden in-flight incapacitation. The purpose of this study was to analyze the cardiovascular abnormalities in pilots involved in fatal general aviation airplane accidents. METHOD: A comprehensive review was performed of all cardiovascular abnormalities detected during autopsies conducted on pilots involved in fatal fixed-wing general aviation aircraft accidents in the U.S. from 1996-1999. Data was obtained from the database maintained at Civil Aerospace Medical Institute in Oklahoma City. RESULTS: An analysis of 534 autopsy reports revealed presence of cardiovascular abnormalities in 234 pilots (prevalence rate 43.82%). Coronary artery stenosis had a prevalence rate of 37.64%. There were 41 pilots who had evidence of severe atherosclerosis of the left coronary artery. This was significantly associated with stenosis of the right coronary and circumflex arteries. There was a statistically significant relation between coronary atherosclerosis and advancing age. DISCUSSION: Although the overall prevalence of coronary atherosclerosis is lower than previously reported, evidence of severe atherosclerosis was found in a relatively high percentage of pilots and may be a cause for concern. The findings have implications for aircrew health education and primary prevention programs. There is also a need for more standardized data collection.