Assessment of hypertrophic cardiomyopathy in potential aircrew

On account of the risks of: (1) sudden death; (2) significant arrhythmias; (3) reduction in effort tolerance due to severe cardiac hypertrophy; (4) syncope; (5) systemic embolism and (6) side effects of drugs used to treat the condition, no patient with established hypertrophic cardiomyopathy should be licensed to fly. This includes those who may have undergone surgery. Those with minor degrees of hypertrophy on 2-D echo may be considered for restricted licensing subject to their having a normal exercise test and no significant arrhythmia on 24 h ambulatory electrocardiogram. If licensed, six-monthly review by a cardiologist should be required.