title: Screening echocardiography of military aircrew candidates: aeromedical implications.
abstract: OBJECTIVE
  Cardiovascular evaluation has a significant aspect in the medical screening process of aircrew candidates. Echocardiography may identify asymptomatic cardiac abnormalities which can jeopardize the aviator and flight safety, as well as conditions which may progress and disqualify a trained aviator. We assessed the value of adding routine echocardiography to the aeromedical screening process.
  
  
  METHODS
  The study population consisted of 17- to 21-year-old healthy aircrew candidates. We retrospectively reviewed all routine echocardiographic studies performed during 1997-2008 at our clinic. Studies performed for a clinical indication were excluded.
  
  
  RESULTS
  A total of 2,657 echocardiographic studies were analyzed. 2,506 were considered 'normal' (94.3%). 151 studies (5.7%) demonstrated findings which required further consideration and were considered 'abnormal'. Additional consideration included limitation to low-performance aircrafts (n = 22, 14.7%), prompt disqualification (n = 23, 15.3%), or further cardiovascular assessment (n = 106, 70% of 'abnormal' studies), which resulted in disqualification of 2 more candidates. Echocardiography resulted in disqualification of 0.94% of candidates, limitation to low-performance aircrafts in 0.83%, and need for follow-up in additional 1.54%.
  
  
  CONCLUSIONS
  Echocardiographic screening affected aeromedical designation and follow-up decisions in 3.31% of candidates. Contribution of routine echocardiography is dependent on aeromedical policies. The Israeli Air Force policies regarding common findings are presented.
authors.affiliation: Aeromedical Center, Israeli Air Force, Tel-Hashomer, Israel. oriwand@hotmail.com
authors.forename: Ori
authors.initials: O
authors.lastname: Wand
authors.forename: Alex
authors.initials: A
authors.lastname: Prokupetz
authors.forename: Amit
authors.initials: A
authors.lastname: Assa
authors.forename: Erez
authors.initials: E
authors.lastname: Barenboim
mesh_terms: D000293:Adolescent; D000337:Aerospace Medicine; D015150:Echocardiography, Doppler; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening; D008889:Military Personnel / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult