SEMINARIO MEDICO OACI. Mexico DF, 6 abril 2011.

Posgrado en MEDICINA AEROESPACIAL

FACULTAD de CIENCIAS MEDICASFACULTAD de CIENCIAS MEDICASUNIVERSIDAD NACIONAL de LA PLATA

ARGENTINA

¨ CARDIOPATIA ISQUEMICA. PREVENCION PRIMARIA en ARGENTINA¨

Vicente R. CIANCIO, Gustavo Di GIOVAN, Pedro OLIVERI Vanina L CIANCIO y Leonardo De BENEDETTIVanina L. CIANCIO y Leonardo De BENEDETTI

Aeropuerto USHUAIA, ARGENTINAEl más A stral del M ndoEl más Austral del Mundo

+2.000 millons Pax / yearJUMBO Boeing 747- 40012 km, + 900 km/h.RUTAS de mas de 14 hs.

100 millons Latinamerica12 millions Argentina

AVIATION WORLD TENDENCYFLIGHT more RAPID, More HIGHER and FAR AWAY in Ultra LONG-HAULNON-STOP INTERCONTINENTAL

AVIATION WORLD TENDENCY

NON STOP INTERCONTINENTAL ROUTES.

CongresoNacional Cardiología

Cordoba,ArgentinaAbril 1970Abril, 1970.

IBEROAMERICAN PILOT ASSOCIATION

ARGENTINE PILOTS ASSOCIATION (APLA)

2008

C.V.32 % Cancer32 %

29 %

9. Cosmic Solar Radiation

Senior PILOTS in Internat. Routes remain 2/3 of Month outside their Homes. The family’s separation induce great Style Life modification: begin with the JET LAG disrupting normal activities with bad Sleep changing AlimentaryJET LAG disrupting normal activities, with bad Sleep, changing Alimentary Habits to fast food, living in Hotels and not Exercising, with the insulation begin or increase tobacco and alcohol habits, etc., all of that induced Stressthat also on a vulnerable personalities conduced to Depressive Syndrome. This condition with the Stressors of Flight increase the C.V. Risk Factors that facilitate the development and proguess of Atheroesclerotic proccess.

AIR CREW MEMBERS

EZEIZA AIRPORT

CROWED AIRPORTSCROWED AIRPORTS

Intercontinental ULTRA PROLONGED FLIGHTS

¨COPKIT QUALITY CABIN¨CRUISE Altitude. 7 to 8.000 Feets

HIPOXIA HYPOBARICAHIPOXIA HYPOBARICASenior Pilot Seated Ox.Sat. 93 to 95 %

Walking 87 to 90 %

PULSEOXYMETER

JET LAG

FAST FOOD and PILS

EXERCISING

30 % ARGENTINEAN PILOTSprsent CV Risk Factors asprsent CV Risk Factors as Sistemic Arterial HipertensionDislipoproteinemia, ObesityTabaquism and SedentarismTabaquism and Sedentarism

6to. CONGRESO de la ASOCIACION IBEROAMERICANAde MEDICINA AERONAUTICA y ESPACIALde MEDICINA AERONAUTICA y ESPACIAL

Buenos Aires, Argentina. octubre 1996.

MESA REDONDA de CARDIOLOGIA AEROESPACIAL“De la PREVENCION a la INTERVENCION”.

Prof. Dr. Rubén BRUSCO¨Epidemiologia de los FACTORES de RIESGO C. Vascular.

Prof. Dra. Liliana GRINFELD Tratamiento Intervencionista en la CARDIOPATIA ISQUEMICA.

Prof. Dr. Rene FAVALOROTratamiento Quirúrgico dn la CARDIOPATIA ISQUEMICA.

( 60% )

21 %

235 DEATHS

21 %

79 %79 %

2008

C.V.32 % Cancer32 %

29 %

YEARS

“C.V. PRIMARY PREVENTION PROJECT for

ARGENTINEAN AIRLINE PILOTS¨

V.Ciancio, P. Oliveri, G. Di Giovan, V.L. Ciancio, L. De Benedetti

Dr. Enrique Gurfinkel

Cardiology Head

FAVALORO INSTITUT Buenos AiresBuenos Aires

2009

160 Corazones de No Cardíacos Ni Diabéticos, edad 45 a 55,Todos con Placas Ateromatosas.57% eran Placas No obstructivas, pero Vulnerables, con 1,1 Placas por Individuo.

Voluntary Pilots aged 40-60 yearsParticipate in the C.V. Study performing Ergometry inperforming Ergometry inthe Hypobaric Chamber

2005 : Inaugurate HYPOBARIC CHAMBER I.M.A. Quilmes, Prov. Bs. Aires..

Video MonitorHYPOBARICCHAMBER

Medical Instrumental

ECGDisplay AtmosphericNitric

AmbientOximeter

Display pPressurometer

NitricOxide

DosimeterPulse

OximeterCO2Laboratory

Instrumental

Cardiodefibrill.Blood Pressure

OxigeniumSources

Computer

Treadmill

RADIOISOTOPIC ERGOMETRY SENSIBILIZED by HYPOXIA y

(8.000 Ft)

TC SPECTTC SPECT

NORMAL

Zero m. NORMAL TEST

TEST ISQUEMICO - NORMALIZADO con Ox2 al 100%.

Fr. Ey. : Fall 53 %

Zero meter: NORMAL, 3000 m: ANORMAL, NORMALIZED with Ox.100%

A

Airline PILOT 50 y, in fullActivity and Ao.Activity and Asyntomatic

CT M. Slice

Basal ECGith tiwith negative

Precordial T.

CT M SLICECT M. SLICE

S C Ob t ti T t d ith STENTSevere Coronary Obstruction Treated with a STENT

Young PILOT: severe IAM inCourse of Flight on Ocean!

PHYSICIAN PILOT 50 y, full CV Risk F. and high Stressat Charge in CCU in Christsmas day.

CT M. SLICE Allow the NO Invasive FOLLOW -UP

AIRLINE PILOTS.

HEALTHY PROFESSION ?

In OCCIDENT C.V. Deseases are a PANDEMIA. In AVIATION is necesary the early detection,and the first

PREVENTION, PREVENTION and PREVENTION !

O s ecesa y t e ea y detect o ,a d t e ststrategy should be related to the Primary Prevention

USHUAIA, Province of Tierra del Fuego, Argentina.

TANK YOU FOR YOURKIND ATTENTION

QUESTIONS…