Document Detail

LBBB in aircrew with low cardiac risk: diagnostic application of multislice CT.
MedLine Citation:
PMID:  16780239     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Because of its excellent negative predictive value for diagnosing coronary stenoses, multislice computed tomography (MSCT) may be a way to assess the absence of significant coronary stenosis. We discussed its place in aeromedical decision-making for aircrew members with a low level of cardiovascular risk factors and acquired left bundle branch block (LBBB). METHODS AND RESULTS: During the period 2002-2004, 12 male aircrew members (mean age: 42.9 yr) with acquired LBBB were admitted to our cardiovascular and aeronautical department. The exploration of LBBB was classical, including an electrophysiological study, the usual coronary angiography, and MSCT. All the morphological explorations of the coronary tree were normal. DISCUSSION: In addition to complex electrophysiological mechanisms, coronary artery disease (CAD) is suspected, but remains infrequent in some EKG findings such as acquired LBBB, especially for patients with low cardiovascular risk factors as demonstrated with our aircrew members. However, in aerospace medicine the expert needs to prove the absence of CAD. The use of standard examinations (exercise stress test, stress myocardial scintigraphy, etc.) is controversial because of artifacts and a conventional coronary angiography is necessary. According to previous studies, including using a validated technique in our department (with 16-slice computed tomography), the excellent negative predictive value of MSCT (97 to 99%) may be a way to avoid invasive exploration during the investigation of a newly acquired LBBB in aviators with low cardiovascular risk.
Eric Perrier; Olivier Manen; Philippe Doireau; Jean F Paul; Said Ghostine; Michel Lerecouvreux; Jacques Deroche; Pierre A Leduc; Marilyne Genero; Jean F Paris; Victor Martel; Roland Carlioz; Sylvie Geffroy; Christophe Caussin; Christian Plotton; Jean P Gourbat
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Aviation, space, and environmental medicine     Volume:  77     ISSN:  0095-6562     ISO Abbreviation:  Aviat Space Environ Med     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-19     Completed Date:  2006-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501714     Medline TA:  Aviat Space Environ Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  613-8     Citation Subset:  IM; S    
Department of Aeronautical Medicine and Cardiology, Hôpital d'Instruction des Armées Percy, Clamart, France.
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MeSH Terms
Bundle-Branch Block / radiography*
Coronary Angiography
Coronary Disease / diagnosis
Electrocardiography, Ambulatory
Exercise Test
Middle Aged
Military Personnel
Risk Factors
Tomography, X-Ray Computed / methods*

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