When is a preflight exercise stress test indicated for aircrew?

• A. In presence of risk factors for coronary disease; not routine for all
• B. For all aircrew annually
• C. Only after a cardiac event
• D. Not routine for any

Answer: (A)

The key idea is selective screening for coronary risk. A preflight exercise stress test is used to uncover inducible ischemia in aircrew who have risk factors for coronary disease, so it helps determine if someone can safely handle the demands of flight without failing under stress. It’s not done routinely for everyone because many asymptomatic individuals with no risk factors won’t benefit from the test, and universal testing can lead to false positives, unnecessary follow-ups, and resource strain.

So testing is indicated when risk factors for coronary disease are present, rather than as a universal annual screen. Post-event clearance can involve broader evaluation, but the standard approach remains targeted testing based on risk factors rather than testing all aircrew or testing only after a cardiac event.