title: Centrifuge-Simulated Suborbital Spaceflight in a Subject with Cardiac Malformation.
abstract: BACKGROUND
  Commercial spaceflight participants (SFPs) will introduce new medical challenges to the aerospace community, with unique medical conditions never before exposed to the space environment. This is a case report regarding the response of a subject with multiple cardiac malformations, including aortic insufficiency, pulmonary atresia, pulmonary valve replacement, ventricular septal defect (post-repair), and pulmonary artery stenosis (post-dilation), to centrifuge acceleration simulating suborbital flight.
  
  
  METHODS
  A 23-yr-old man with a history of multiple congenital cardiac malformations underwent seven centrifuge runs over 2 d. Day 1 consisted of two +G(z) runs (peak = +3.5 G(z), run 2) and two +G(x) runs (peak = +6.0 G(x), run 4). Day 2 consisted of three runs approximating suborbital spaceflight profiles (combined +G(x) and +G(z)). Data collected included blood pressure, electrocardiogram, pulse oximetry, neurovestibular exams, and post-run questionnaires regarding motion sickness, disorientation, greyout, and other symptoms. Despite the subject's significant medical history, he tolerated the acceleration profiles well and demonstrated no significant abnormal physiological responses.
  
  
  CONCLUSIONS
  Potential risks to SFPs with aortic insufficiency, artificial heart valves, or valvular insufficiency include lower +G(z) tolerance, earlier symptom onset, and ineffective mitigation strategies such as anti-G straining maneuvers. There are no prior studies of prolonged accelerations approximating spaceflight in such individuals. This case demonstrates tolerance of acceleration profiles in an otherwise young and healthy individual with significant cardiac malformations, suggesting that such conditions may not necessarily preclude participation in commercial spaceflight.
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Blue
authors.forename: Eric
authors.initials: E
authors.lastname: Blacher
authors.forename: Tarah L
authors.initials: TL
authors.lastname: Castleberry
authors.forename: James M
authors.initials: JM
authors.lastname: Vanderploeg
mesh_terms: D000054:Acceleration; D000328:Adult; D000337:Aerospace Medicine; D002498:Centrifugation; D003971:Diastole / Q000502:physiology; D006330:Heart Defects, Congenital / Q000503:physiopathology*; D006801:Humans; D008297:Male; D013026:Space Flight; D013599:Systole / Q000502:physiology; D055815:Young Adult