This article was prepared by Phillip A. Strawbridge, M.D., M.P.H., and Isaac Yourison, M.D., M.P.H.
You are the flight surgeon for a 39-yr-old active-duty male who presents for initial qualification examination for duties as a remotely piloted aircraft (RPA) pilot. He was previously qualified as an RPA sensor operator (SO) approximately 10 yr prior. During that RPA SO qualification exam, he had a chest X-ray (CXR) that was notable for cardiomegaly without any comment on the status of his diaphragm. At that time, he did not note any symptoms, including chest pain, shortness of breath, or abdominal pain. Further evaluation with