Three cases of flying personnel with apical hypertrophy cardiomyopathy and literature review

Abstract

Objective To discuss the influence of apical hypertrophy cardiomyopathy (AHCM) on the flying personnel's and the evaluation principle of aeromedicine. Methods The clinical AHCM data, including diagnosis, therapy and prognosis of three pilots were analyzed and related literatures were reviewed. Results Three flying personnel cases were without clinical symptoms but were diagnosed as AHCM according to abnormal electrocardiogram and echocardiogram in physical examination. In 24-year follow-up of case 1 the ECG showed T wave inversion upon V3, V4 leads and the amplitude raised from 0.4 mV to 0.9 mV, the thickness of apex cordis increased from 12 mm to 19 mm. But he had safe flight for 19 000 h. Case 2 showed T wave inversion upon V3-V5 leads and the amplitude changed from 0.5 mV to 1.4 mV, the thickness of apex cordis varied from 12 mm to 24 mm in 22-year follow-up. He had safe flight for 20 000 h. Nine-year follow-up was taken for case 3 that also appeared T wave inversion on V5 lead, amplitude changed from 0.2 mV to 0.6 mV and the thickness of apex cordis increased from 12 mm to 17 mm. He had safe flight for 1 000 h. Conclusions Early diagnosis of AHCM will benefit to take the clinical follow-up for flying personnel. Due to the good prognosis the qualification could be issued to the flying personnel with AHCM but must be with strict supervision. The individual evaluation is also suggested. Key words: Cardiomyopathy, hypertrophic; Eligibility determination; Rstricted flying; Aircrews