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The management of coronary artery disease (CAD) in aviators remains as one of the dominant preoccupation in determining vocational fitness. With the emerging awareness and accessibility of non-invasive modalities for assessing CAD, there is an increasing likelihood that aircrew may have undergone some form of functional or anatomic assessment of the coronary circulation, prior to their presentation to the aviation medical examination office. In particular, computer tomographic coronary angiography (CTCA) and CT coronary artery calcium sc