Beyond a ‘wing and a prayer’: building the evidence base for aviation cardiology

The well-being of pilots and other aircrew is paramount to flight safety, and appropriate risk management of pathology in aircrew is central to the delivery of aviation medicine. Aviation and space medicine has recently become a recognised specialist field of medicine, in recognition of the specific knowledge requirements to understand both the unique physical environment of air and space and the physiological demands placed on aircrew who work therein. The screening of aircrew focuses heavily on the cardiovascular system, with regular ECG assessment performed as part of periodic medical examinations (PME), which are required as part of the certification process for aircrew licensing. Abnormalities found at the PME, even if mild, often lead to flight privileges being restricted or withdrawn …