Q: 44 year old air-force pilot is brought to ED after his flight with chest pain, and dyspnea. Patient describes these symptoms progressively getting worse after each air flight. What is your diagnosis?
Answer: Acceleration atelectasis
Acceleration atelectasis can occur in pilots who are subject to very high, vertical accelerative forces between 5G and 9G. half of the pulmonary airways are distorted and closed at 5G due to gravitational forces. This leads to atelectasis which gets worse by superimposed breathing of high fractional concentration of oxygen. Progressively these pilots may have decrease in vital capacity.
Slide presentation @ Acceleration Atelectasis: New risks from an old friend ( by Ross Pollock
and Alec Stevenson) - (courtesy of QINETIQ PROPRIETARY)
Tacker WA Jr, Balldin UI, Burton RR, et al. Induction and prevention of acceleration atelectasis. Aviat Space Environ Med 1987; 58:69.