Which statement accurately describes when a preflight cardiovascular risk assessment is indicated?

• A. It is routine for all aircrew
• B. It is indicated in the presence of risk factors for coronary disease; not routine for all
• C. It is never indicated
• D. It is required only after a medical event

Answer: (B)

Assessing cardiovascular risk before flight focuses on identifying aircrew who have factors that raise the chance of a coronary event during duty. This is a targeted screening, not a blanket test for everyone, because most aircrew do not have these risk factors and routine testing can lead to unnecessary investigations and grounding.

The indication comes from the presence of risk factors for coronary disease. Typical factors include high blood pressure, diabetes, high cholesterol, smoking, obesity, a family history of premature heart disease, and a sedentary lifestyle. When these are present, a preflight cardiovascular risk assessment helps determine whether further testing or clearance is needed before flying.

It isn’t done for all aircrew by default, and it isn’t never indicated—there are clear circumstances where it’s appropriate. It isn’t limited to post-event scenarios either; while a medical event prompts its own clearance process, the routine trigger for preflight risk assessment is the existence of risk factors, not the absence of events.