title: Post-exercise time-course analysis of ST segment and T wave changes: an important contribution to the role of stress electrocardiography in aircrew.
abstract: Flight surgeons recognize that ongoing vigilance is necessary to detect coronary artery disease (CAD) in aircrew. Regular physical examinations with only a resting electrocardiogram, albeit having a very low predictive value for detection of CAD in asymptomatic subjects, are now widely practised. Routine stress electrocardiography has been criticized for yielding too many so-called "false positive" results because ST/T changes that develop during and after exercise are prevalent. Recent studies in our institution indicate, however, that the time-course behavior patterns of these ST/T configurational "abnormalities" after exercise are different from those reflecting myocardial ischemia due to epicardial CAD. Time-course analysis increases the predictive value of exercise testing and has dramatically decreased the number of asymptomatic aircrew being subjected to coronary arteriography in our institution. Routine exercise electrocardiography provides a reliable, cost-effective means of detecting aircrew with CAD and a baseline for comparison at subsequent examination, and we strongly recommend that it be universally reinstated.
authors.affiliation: Institute of Aviation Medicine, Pretoria, South African Airways.
authors.forename: C W
authors.initials: CW
authors.lastname: Barlow
authors.forename: E R
authors.initials: ER
authors.lastname: Soicher
authors.forename: J B
authors.initials: JB
authors.lastname: Barlow
authors.forename: B M
authors.initials: BM
authors.lastname: Friedman
authors.forename: D P
authors.initials: DP
authors.lastname: Myburgh
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013312:Stress, Physiological / Q000503:physiopathology*