Coronary artery ectasia : aspects of fitness to fly.
European Workshop in Aviation Cardiology. Symposium. Hanbury Manor, GBR, 1998/06/24.
Coronary artery ectasia is defined as dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal artery.
The diffuse form should be differentiated from discrete aneurysms and those due to Kawasaki disease.
Coronary artery ectasia is seen in up to 5% of arteriographic, and in 0.22-1.4% of autopsy series.
It is considered a generalized manifestation of the atherosclerotic process but with a predilection for the media.
The great majority of patients with coronary artery ectasia have co-existing coronary artery disease, which is accompanied by hyper-lipidaemia, and indicated by angina (71%) and previous myocardial infarction (62%). The overall clinical picture and course of these patients is indistinguishable from that of co-existing coronary obstructive disease.
Patients with pure ectasia (15% of the total population with coronary artery ectasia) have a more benign course, but the effect of a previous myocardial infarction is seen in 39%, and 32% develop unstable angina, myocardial infarction or death within 5 years.
Myocardial infarction is believed to be caused by co-existing risk factors and slow flow.
Patients with coronary artery ectasia and co-existing coronary artery disease should be considered unfit to fly.
Only asymptomatic patients with pure ectasia, with no evidence of myocardial ischaemia on myocardial scintigraphy, may be considered for flying status.
Mots-clés Pascal : Anévrysme, Artère coronaire, Homme, Transport aérien, Licence, Physiopathologie, Analyse risque, Qualification professionnelle, Exploration, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Artère pathologie, Cardiopathie coronaire
Mots-clés Pascal anglais : Aneurysm, Coronary artery, Human, Air transportation, Licence, Pathophysiology, Risk analysis, Professional qualification, Exploration, Cardiovascular disease, Vascular disease, Arterial disease, Coronary heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0220652
Code Inist : 002B12A03. Création : 16/11/1999.