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A 44-yr-old male pilot was diagnosed with non-ischemic cardiomyopathy, possibly as a complication of hereditary hemochromatosis, 8 yr after an acquired left bundle branch block was discovered on a routine ECG. Biochemical testing returned high levels of iron and percentage transferrin saturation, and genetic testing for hemochromatosis was remarkable for a heterozygous H63D mutation in the HFE gene on chromosome 6. Hereditary hemochromatosis should be considered in the differential diagnosis when a patient presents with cardiomyopathy and genetic testing for HFE gene variants influencing iron overload is now available as a clinical adjunct for diagnosis and patient management issues. Cardiomyopathy and symptomatic hemochromatosis are aeromedically disqualifying conditions in the U.S. Air Force; however, early identification of hereditary hemochromatosis susceptibility with biochemical or genetic diagnostic tests, followed by education in primary and secondary prevention, will prevent a significant proportion of the possible sequelae.

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Aerospace medicine has evolved into a legitimate specialty through a long process of historical observation and technical achievement. However, most public literature on the topic has only covered information written through the late 1960s. This paper seeks to give a brief overview of the development of aerospace medicine and includes information about early advances in the field as well as more recent data. A MEDLINE search using “history,” “aerospace medicine,” and several other search terms as subject headings was the first step in gathering data. Also, personnel from the U.S. Air Force School of Aerospace Medicine library at Brooks AFB, TX, were consulted for current literature on the subject. From the earliest descriptions of mountain sickness, to the first manned balloon flight, and on to the invention of the airplane with man's forays into space, aerospace medicine has had a rich history. A great part of this rich history was contributed by pioneers, both past and present, of the U.S. Air Force.

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In the foreseeable future, private companies will manufacture space vehicles with a capacity of transporting tourists into low Earth orbit. Because of the stresses of spaceflight, the effects of microgravity, and limited medical care capability, a system of medical clearance is highly recommended for these space tourists. It is our purpose to establish guidelines for use by private businesses, medical providers, and those planning on being a space tourist. Consequently, a Task Force was organized by the Aerospace Medical Association (ASMA) for the purpose of facilitating safety of passengers, fellow passengers, crew, and flight operations. The guidelines are meant to serve only as a template with the full expectation that exceptions might be made with appropriate rationale.