Aeromedical Assessment in Adults with Congenital Heart Disease: A Retrospective and Descriptive Cross-sectional Study

Abstract

The aim of this study was to determine the epidemiological and clinical characteristics of Congenital Heart Disease (CHD) in aircrews. Another aim was to inform decision-making based on clinical risk, aircraft type and aeronautical function. This retrospective cross-sectional study was conducted at the aeromedical Expertise Center of the Mohamed V Military Teaching Hospital in Rabat, Morocco, from 1 January 2022 to 31 December 2024, covering all aircrew members who were seen during the same period for both admission and review visits. There were 10737 medical visits, including 6 cases of CHD. The prevalence was 0.55 per 1000 with a sex ratio of 1:1. The average age was 31.7, all civilians. There were 4 admission visits (66.7%), including one class 1 candidate and 3 class four candidates and two revisional visits for a captain and an air hostess.The clinical examination was normal. Electrocardiogram revealed repolarisation disorders in 50% of the individuals, particularly in the septo-apico-lateral and inferior territories. Four had a Myocardial Bridge (MB) and two an Atrial Septal Defect (ASD) of the Ostium Secondum (OS) type. Four were declared fit (66.66%). The two candidates declared unfit were the air hostess with a wide ASD of 15MM with right heart répercussions and the candidate pilot on admission with MB with a significant MILKING effect of distal LAD. Advancements in diagnostics and therapeutics will lead to an increased prevalence of adults with CHD in the coming years. Consequently, further longitudinal studies will be necessary to monitore the interaction of these conditions with the aviation environment and finally to harmonize fitness decisions.