To the Editor.—
In a recent answer concerning the Wolff-Parkinson-White syndrome (224:1538, 1973), Dr. J. Robert Dille observed that Federal Aviation Administration (FAA) airmen examinations do not require routine electrocardiograms until age 35 "and only for holders of first class certificates."Dr. Malcolm Carruthers1 has recently noted that physical examination and electrocardiography have limited utility in detecting early coronary heart disease. He further stated that "exercise tests do little to improve diagnostic precision, and are unpopular with aircrew, to the point being a strike issue." Dr. Carruthers presents appropriate arguments for the desirability of physical fitness and good life habits (including eating and smoking less) in his article. He advises graded exercise programs for British pilots to prevent ischemicheart disease.As a one-time flight surgeon, I am aware of the negative attitude that pilots have to any test that might serve to ground them. But as a cardiologist, I
Miller AJ. Exercise Tests for Pilots. JAMA. 1974;227(1):77. doi:10.1001/jama.1974.03230140047020
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