A pilot with vasovagal syncope: fit to fly?: Difference between revisions

Vasovagal syncope is described as a benign condition, while the mortality of patients due to vasovagal spells is very low [2]. However, loss of consciousness in a critical situation like driving or flying could lead to serious accidents. According to the European criteria of the Joint Aviation Authorities (JAA), pilots with loss of consciousness can only be declared fit to fly when there is no chance of recurrence, the cause of syncope is clear and neurological examination shows no abnormalities [4].  

According to the United States Federal Aviation Administration (FAA), a first syncopal episode makes a pilot unfit to fly. Only if there is a clear and avoidable medical explanation for the episode the pilot can be declared fit to fly [4]. This criterion may be applicable to pilots suffering from vasovagal syncope induced by medical situations [1].   

Whether a pilot with vasovagal syncope can be declared fit to fly depends upon the possibility of recurrences during flight. To determine the risk, the vasovagal nature of the syncope must be absolutely certain [5]. Secondly the patient should have clear prodromi, to make sure precautions can be taken in case of symptoms. Awareness of provoking situations is crucial to allow precautions to be taken at an early stage [6]. The provoking factor should be avoidable during flight. A restriction to fly ‘as or with a co-pilot’ during a certain observational period may be considered as a first measure to resume flying [6].