ABSTRACT
Adult congenital heart disease (ACHD) is uncommon in aircrew; however, with advances in childhood surgery and adult care, an increasing number of individuals with ACHD seek advice with regards to flying, both in the civilian and military sectors. The aeromedical significance of ACHD will be determined by the potential physiological consequences of the underlying pathology in the aviation environment. All aircrew with a suspected diagnosis of ACHD require extensive investigation and usually require restriction or grounding whilst these are undertaken. Anomalous coronary anatomy is present in around 1% in the general population; may be identified following an abnormal 12-lead or exercise ECG. Isolated Ventricular Septal Defect (VSD) accounts for about a third of simple ACHD. Small VSD may cause a palpable thrill and loud pan systolic murmur. VSD associated with an increased risk of endocarditis.
