Epidemiological and Aeromedical Risk Assessment of Congenital Heart Disease in Aircrews: A Study at Mohamed V Military Teaching Hospital in Rabat, Morocco | Chapter 9 | Medical Science: Recent Advances and Applications Vol. 3

Congenital heart disease (CHD) is the most prevalent congenital disorder. This is one of the most common causes of death derived from malformations. Historically, its treatment has depended on timely diagnosis and early pharmacological and surgical interventions. Survival rates for patients with this disease have increased, primarily due to advancements in therapeutic choices, but mortality remains high. Certain CHD conditions may manifest in individuals already engaged in aircrew duties. It is essential to be able to manage the risk assessment of CHD and to provide appropriate clinical and occupational counsel when deliberating about actual or potential aircrew duties. This study aimed 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 Centre 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. Data were collected and analysed using Jamovi software (version 2.3.28). 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 had an Atrial Septal Defect (ASD) of the Ostium Secundum (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. Suitability decisions for candidates with CHD are made on a case-by-case basis.

With continued advancements in diagnostics and therapeutics, the number of adults with CHD is expected to rise. Consequently, further longitudinal studies need to be conducted to monitor the interaction of these conditions with the aviation environment and finally to harmonise fitness decisions.

 

Author (s) Details

 

Landing Souané
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Zakaria Iloughmane
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

 

Meryem Zerrik
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Mouna El Ghazi
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Fahd Bennani Smires
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

El Khalifa Sidi Mohamed
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Khadidiatou Faye
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Fatima Zohra Tlemcani
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Maktit Safaa
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Isouphou Hamidou Adarka
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Houda Echchachoui
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

Mohamed Chemsi
Aeromedical Expertise Center, Mohamed V Military Teaching Hospital, Rabat, Morocco.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v3/5350

Ultra-Structural Alteration of Human Coronary Arterial Endothelium with Myocardial Bridge | Chapter 4 | Research Aspects in Biological Science Vol. 4

 

"Myocardial bridge" was the term for the heart muscle fibre that covered the coronary artery segment. Because the myocardial bridge caused endothelial damage to the coronary arteries, it was linked to coronary atherosclerosis and myocardial ischemia. In the current work, the myocardial bridge was used to examine the ultrastructural alterations of the coronary artery endothelium in human adult postmortem hearts. The study compares calcium depositions and endothelial characteristics under scanning electron microscopy in four different coronary artery segments. The North Okkalarpa General and Teaching Hospital in Yangon is where the sample was taken. Among the 243 cases, 45 adult autopsied hearts exhibited myocardial bridges that had been measured for length and thickness. Then, in the same postmortem hearts, a segment from the coronary artery without a myocardial bridge and three portions of the coronary artery from the proximal, beneath, and distal segments of the coronary artery with a myocardial bridge were extracted to serve as controls. With the use of an energy dispersion X-ray spectrometer and a scanning electron microscope (Phenom Pro X) operating at 15 kV, the endothelial characteristics and elemental composition of each specimen were studied (EDS). In the current investigation, out of the 243 hearts, 45 bridges (18.5%) were found, and 100% of them were found on the left anterior descending artery (LAD). The myocardial bridge measured an average of 18.3 mm by 11.7 mm (range 1.5-59 mm). The myocardial bridge was 2.8 mm on average with a 1.5 mm variance (range 1-6.3 mm). The proximal segment had a significantly different endothelial grading from the under-bridging segment, distal segment, and control segment when endothelial cell gradings were compared. The distal segment was very different from the under-bridging segment. The distal portion and the under-bridging segment did not differ significantly from the control segment. Comparing the proximal segment to the under-bridging segment, distal segment, and control segment, calcium deposition was significantly different. Similar calcium deposits were found in the distal segment and control segment of the under-bridging section. The distal segment did not change from the control segment appreciably (P 0.05). Due to the haemodynamic alterations brought on by the myocardial bridge, the proximal segment sustained the most endothelial damage. The myocardial bridge in the under segment may have an atheroprotective effect because it was the endothelial damage location with the least amount there.

Author(s) Details:

Sann Lin Ko,
Department of Anatomy, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar.

Thin Thin Win,
Department of Anatomy, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar.

Khine Zaw Oo,
Defence Services Medical Research Centre, Nay Pyi Taw, Myanmar.

Tun Tun Win,
Department of Preventive and Social Medicine, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar.

Aye Moe Moe Kyaw,
Department of Anatomy, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar.

Please see the link here: https://stm.bookpi.org/RABS-V4/article/view/7587