Coronary artery disease and preventive cardiology in aviation medicine.

A review of 6,500 autopsied cases on record at the Armed Forces Institute of Pathology of deaths occurring in aircraft accidents or mishaps revealed that 816 cases (13%) had been diagnosed as heart disease other than traumatic (i.e., pre-existing at the time of the accident). Of these 816 cases (592 military and 135 civilian), 89.1% had atherosclerotic coronary artery disease (CAD). This autopsy series compared the severity of CAD, year of death, and crew position within the military 5-year age groups. CAD was found in 86.6% of the 20- to 34-year-old military group. Moderate and severe CAD was present in 17.1%. CAD in previous autopsy studies of U.S. military casualties in the Korean and Vietnam conflicts was reported as 77.3% and 45%, respectively. Study of severe and moderate CAD by year of death in the 20- to 34-year age group demonstrates 26.2% in 1965-1969 and 21.1% in 1970-74. These findings do not support the conclusion of the Vietnam autopsy study that CAD is decreasing. Preventive and predictive cardiology in aviation medicine should be instituted early and aggressively in the young aircrew population.