ABSTRACT
The incidence of acquired valvular heart disease (VHD) has fallen with the reduction in rheumatic heart disease but does still occur in aircrew. Congenital valve disease is common and is often asymptomatic until later in life. Due to periodic medical examinations, asymptomatic aircrew with VHD may be detected secondary to ECG changes, or murmurs, on clinical examination. Assessment of VHD is like that of adult congenital heart disease (ACHD), both for native disease and following intervention. Bicuspid aortic valve disease is the most common form of ACHD. Pulmonary stenosis may occur in isolation or as part of a wider constellation of congenital heart defects (CHD). Fitness to fly is dependent on disease severity, and after exclusion of additional CHD, decisions based on the same criteria as acquired disease. Valve degeneration may involve leaflet thickening and/or calcification. Mitral valve disease is uncommon in aircrew.
