Computer tomography coronary angiography as an alternative to invasive coronary angiography in the assessment of coronary artery disease in aircrew

Cardiac risk evaluation during the medical fitness of aircrew is stringent due to the strenuous nature of their employment. Cardiac risk assessment by various risk scoring tools, coronary artery calcium score, stress tests, and more recently computerized tomography coronary angiography (CTCA) have been employed to objectively assess, predict, and prevent catastrophic cardiac events. Here, we explore the potential use of CTCA in place of invasive coronary angiography for assessment of coronary artery disease in aircrew. With the advancement of hardware and software, the CTCA is able to not only define the luminal occlusion but also its functional significance and pathological state in the surrounding vessel wall. This could thereby avoid invasive procedures and the complications associated with them.