Hangar Talk: Expert Forums: Medicine (ARCHIVE): Disease: Cardiology
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My 18 year old son wants to be an Airline Pilot. When he was 10 he was diagnosed
with Wolf Parkinson White. He had a successful ablation procedure and his EKG is
now normal. Your advise please. David B
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At the time of his medical, have him present to his AME, a letter from his
doctor indicating his history and current status, stating essentially, that
he is normal. Also have him bring in a recent EKG. Usually WPW is not a factor.
Dr. Roberts
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My freind who is a 31 years old male with mitral valve prolapse recently. He had to see a doctor
for his MVP. The result was neither treatment nor meditation. He wants know about get medical class
1 possible? Seo
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Yes it is possilbe, but he will have to request a special
issuance through the FAA.
Dr. Roberts
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I had 2 months of angina and then (Oct'97) a 4X CABG + 6 mos. rehab, afterwhich
(July'98) I passed the required tests, including Thallium X-ray, stress tests,
complete blood chem. (Clorestrol = 122) etc. III Class medical Cert. was
received Jan'98 expireed July'99). Naturally, I'm unhappy about the
oversights myself and GP, and AME, and Cart. made that delayed FAA issuance due
to "paperwork ommissions". Now, I'm talking to a different AME and he says field
AME's now have greater authority than before (i.e., OKC has loosened their
strings somewhat) and that he MAY be able to issue III Class on the day of my
visit, PROVIDING ALL THE NEW DATA AND TEST RESULTS ARE FAVORABLE! (Needless to
say, my "new" AME has working relationships with my GP and Cart. whereas my
post-op AME didn't know GP or Cart. from ADAM). What do you think about that?
Can AME issue Certs. with my background "on the spot"? PS There is another AME
who also has office "at the airport" and that is Dr. Joe Levin, Medford Lakes, NJ
at South Jersey Airport (VAY).Evert
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The AME may issue if you have a letter from the FAA allowing him to do
so. That letter will usually state that you need to supply the AME with a current report,
stress test, etc.
Dr. Roberts
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I had a triple by pass with mitral valve resection and repair with a 27 mm. annuplasty ring.
Recovery has been excellent. Is the mitral valve resection and and St Jude annuplasty ring
disqualifying for a third class medical? Dale
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You will most likely be successful in obtaining your medical thru the
special issuance process. You will need a letter from your cardiologist, a stress test, and
all of your medical records pertinent to your surgery sent to the FAA.
Dr. Roberts
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I am a 28 year old male. After noticing what I believed was an irregular heart beat
(a short "pause"), I had an EKG done. The doctor told me I have a left posterior hemiblock.
Is this disqualifying? Chris L
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As long as you are not experiencing lightheadedness or pain, I doubt it
will be a problem. But you will have to
request a special issuance. Get a letter from your cardiologist, an EKG and
a stress test, for submission to Oklahoma City.
Dr. Roberts, SkyDoc
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My Dad has been a recreational pilot for the past ten years. He has a Rec Pilot
license, and fly a Taylorcraft. Late last fall, he went to the hospital with
chest pains. He wound up getting a triple bypass. The doctors said that there
was very little to no damage done to his heart. He is anxiously now awaiting the
OK from his doctor to be able to take his flight physical. Assuming he passes
the third class physical, what is the rest of the process required to regain
flight status? Thanks, David
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Your father has to submit ALL of his medical records to the FAA along with a current
status report from his cardiologist and a stress test. The stress test must be within
the last 6 months, and 6 months must lapse since the surgery before he can apply.
Dr. Roberts, SkyDoc
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I'm as 39 year old male. About 4 months ago I started to feel my heart skip beats. I went to
the Dr. and was told I have Pre Ventricle Contractions. Did a Holter monitor and was told
they were unofficial. No one seems concerned about it, they say it's benign. What do the Feds say?
Do I need to tell them?
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Yes they are benign, generally. But you will still need to request a special
issuance from the FAA. Submit a letter from your cardiologist indicating same,
along with an EKG and stress test.
Skydoc
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This is a follow up question to the "Skipped Heartbeat" recently posted.
Both my father and I hold third class medicals, and both have occasional heart skips. Both our
AME's tell us that these skips are of no concern to the FAA, and to forget about them, since much
of the general population has them. (two different AME's) Whats up here?
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The standards state that all cardiac arrythmias, except for
extrasystolic beats (which apparently you have) are disqualifying.
Dr. Roberts, SkyDoc
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Rd Roberts I am a 50 year old airline captain who loss license in 1990 due to cardiamyopathy. Had
a very successful Heart transplant in 1996. Any chance of a 3rd class for a private pilots license? Robert
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No... at least not at this time. More data needs to be studied with regard to survivability,
complications, medications, etc.
Dr. Roberts
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I was diagnosed as a teenager with familial Dilated Cardiomyopathy.
I am currently 26 years old. No symptoms, no episodes, nothing.
My doctor stated that my last echo was completely normal.
I am on Coreg right now. I was wondering what my odds were for getting a
third class medical cert. for a private pilots license. Thanks in advance! Rob
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The odds are good you will get a third class medical, but you will have to go
through the special issuance process. This means you will have to have your
doctor submit a supportive letter, outlining your diagnosis, what meds you are
on, results of tests, etc.
Goodluck, and happy flying!
Dr. Roberts (SkyDoc)
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I had a Bjork-Shiley aortic valve implant in 1985. The good news is that I have
been flying under a special issuance medical ever since. The bad news is that
the annual required stress test and echocardiogram cost more than $1000. Is
there any way I can request some relief from these tests? I understand that some
documentation will always be required, but my cardiologist thinks these tests on
an annual basis are overkill for my particular condition. In fact, he would not
prescribe them at all if it wasn't for the FAA requirement. Thanks, kevin.
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The only thing I can offer you is to suggest that you have your cardiologist send
the FAA a letter, asking if they can change testing to every other year, based on
your track record. You might want to call the AOPA and talk with the guys in
medical to see what they say. Let me know what they say, so I can pass it on to
others.
Dr. Roberts (SkyDoc)
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My Question Is: Can I get a FAA medical to fly legally? I have a permnent pacemaker
installed 7-9-92 I have 30 day telephone checks as well as an annual visit to heart
specialist who installed it. I fly a Microlite -Team Hi-max. I would like to fly FAA
liscensed airplanes. Thank You, Robert.
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Pacemakers are disqualifying. Sorry!
Dr. Roberts (SkyDoc)
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I am 58 and had a stent set in the anterior decending artery three years ago. I
have had annual stress echos with no adverse findings. I am on Accupril (40 mg),
asprin and Lipitor. What might I need to get my 3rd class medical again? Paul
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You will need to submit ALL of your medical records along with a summary letter
from your treating cardiolo- gist, requesting a special issuance. Generally, if
the stress test is normal, you can expect issuance.
Dr. Roberts (SkyDoc)
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Failed medical in 94. Diagnosed as having Ischemia. Have lost weight. Blood pressure hovering
around 140 over 80. Feeling real good. Never had any real discomfort. Chances for reobtaining?
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Sure. You will need to have a treadmill stress test done. It it is normal, you can
apply for a special issuance.
Dr. Roberts (SkyDoc)
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I am applying for a flying job with an airline, but during a recent medical, the doctor told me
I have Wolf Parkinson White, not the classic case of the WPW but a variant of it. I do not
show any symptoms whatsoever. What are my chances of getting a Class 1 medical? Thank you.
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You probably can get it, but you will needa letter from your MD. stating you a symptom free,
along with an EKG.
Dr. Roberts (SkyDoc)
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I recently have been diagnosed with mitral valve prolapse without any murmur.This was done by
an echocardiogram. I was placed on atenolol to control my pulse that sometimes is 110 at rest
but sinus rhythm. Had stress test that is negative for ischemic changes ; chol of 187 ;HDL 52;
LDL 120; I am 33 and in otherwise good health. Does this now keep me from flying until I get
FAA medical clearence for my 3rd class mesical? If so how do I do it?
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Have your cardiologist submit a summary letter along with copies
of ALL tests done. Apply for a special issuance.
Dr. Roberts (SkyDoc)
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I am a 39 year old female diagnosed with mitral valve prolapse. No symptoms, no treatment, nor
medication. Is MVP a disqualifying condition? Thanks.
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As long as the mitral valve prolapse doesn't cause any adverse symptoms, you will
be able to fly. You will need to give your AME a letter from your doctor
indicating that you have MVP that is asymptomatic.
Dr. Roberts (SkyDoc)
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What is Atrial Fibrillation? How can it be detected and varified? Can you still obtain a
first or second class physical with this condition?
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It is a condition in which the atrial chamber twitch, but do not fully contract. The problem
with that is that cardiac output is decreased. It can be controlled by medication.
You can get a special issuance, assuming it has been adequately controlled.
Dr. Roberts (SkyDoc)
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Doc, I had angioplasty in Sept of 1989 and have had a 3rd class as soon as I was elegible. Do
you think there is any chance of getting a full two year 3rd class? The stress test and blood
work is very expensive once a year. Thank
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Yes, have your cardiologist indicate in a letter that you have been stable
since 1989, and he sees no medical need to do a stress test every year.
Request one every two years.
Dr. Roberts (SkyDoc)
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I am a 66 yr old male. I have a current 3rd class medical. Within the past 6 weeks
it was discovered that I had a blockage which required a stent in my right coronary
artery. May I still fly using my current medical? Jim
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No. The FAR's require you not to fly once you have experienced
any debilitating condition. You need to submit to the FAA a letter from
your cardiologist outling your condition, what was done, medications you
are now taking, and a thallium treadmill. If all that is normal, you
should be able to regain your third class medical.
Dr. Roberts (SkyDoc)
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Angiogram after chest pains showed 90% blockage in 1 coronary artery and 70%
blockage in the other 2. A stent was placed in 90% blockage and for the past year
I have been symptom free. Is it possible to regain my 1st class medical with a
successful thallium stress test or will it be necessary to have an angiogram. Robert
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They probably wont give you a first class, but you most likely will get a second or
third class medical. As for the angiogram, I doubt it, as long as your thallium
stress test is normal.
Dr. Roberts (SkyDoc)
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I am a 46 year old male. I had atrial fibrillation (with no known cause or
symptoms), corrected with cardioversion two months ago. I will be on cordarone
for another month and then plan to apply for my third class medical. I run every
day and have never had any symptoms. I gather I am likely to get my medical
certificate, but is there a way to expedite the FAA process (apparenlty a 3-4
month delay) since my medical expired and I'm grounded? Tim
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There is nothing you can do to speed up the process.
Dr. Roberts (SkyDoc)
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54 year old male who has had episodes of paroxysmal atrial fibrillation. Never
required cardioversion. Presently taking Betapace and digoxin. Normal Thallium
Stress test. Can I renew my third class medical? Charles
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Probably so, as long as you are not symptomatic and the
medications are controlling the condition. I suggest you get a letter
from your cardiologist indicating the diagnosis, what medications you
are on and the doses, a copy of a stress test and possibly a 24 holter.
It will require a special issuance.
Best of luck. Dr. Roberts (SkyDoc)
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My question is very similar to several I have seen, but my case is a little bit
different. I am a 45 year old male who had a heart attack (MI) at age 29 followed
by double bypass surgery. Then at age 37 I had symptoms and a subsequent
angioplasty. I have been symptom free since that time (1989) and just recently
(June 1997) had a very good report from a thallium scan. I started taking flying
lessons about 2 weeks ago. My question is: Having had the two episodes of
heart problems, do you think I will be able to get a medical certificate? Phil
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Dear Phil, The bottom line is the thallium scan. As long as it is OK, then you
probably will be able to get a special issuance.
Dr. Roberts (SkyDoc)
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My father-in-law has a right branch bundle blockage. His Cardiologist (Not an
AME or pilot!) wrote a letter stating he was uncomfortable with reissuance of a
valid medical. What are the chances of a favrable letter from another Dr. allowing
a Class 3 medical so he can fly again? Phil
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Usually a pilot with a right bundle branch block can fly, as long as the pilot is
free of any symptoms. He needs to go to another cardiologist for an opinion. He
will need to give the FAA a letter from the Dr. along with an EKG and stress test.
Usually Rt. bundle branch blocks don't cause problems in otherwise healthy
individuals.
Dr. Roberts (SkyDoc)
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Is the situation the same for people like myself who have had a "stent"
device implanted in the heart artery? ie. EKG, letter from cardiologist, etc.? charles
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Charles, yes the process is the same, but they will probably
want to look at all your medical records, such as the operation
report, post-op tests, treadmills etc. What they are really looking for
is near-normal or normal post-op stress testing (factored for you age).
Best of luck.
Dr. Roberts (SkyDoc)
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After flying with me, my father is interested in taking up the sport. He had a
triple bypass seven years ago. What are his chances of obtaining a third class
medical? I'm guessing this would be a special issuance. He has passed a thalium
stress test. Charlie
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More than likely, yes, via special issuance he can get third class medical. Submit
a letter of
support from your cardiologist along with a copy of the stress test.
Dr. Roberts (SkyDoc)
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I am a 27 year old ATP with a cholesterol level of 222. I have no other health
problems. I am 6' tall and 235 pounds. I am loking for information on how to
lower my cholesterol and lose weight. I have just begun an excersize program but
am not sure where I should concentrate my efforts. Are there and vitamins or
supplements that I could take that would help my condidtion and still enable me
to fly? I am anticipating some major airline interviews within the next year and
would like to be in good shape for those medical exams if I were lucky enough to
get one. I am willing do do what ever it takes but I just need some professional
direction. Any help would be appreciated. Ray
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Studies are showing that time-released niacin may be effective
in reducing cholesterol levels. Most important is a low fat diet, about
20-30 grams of fat per day, and going for a 30 minute walk at least
three times per week.
Dr. Roberts (SkyDoc)
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Can a person who has had successful prosthetic aortic valve implant (St Jude's)
surgery, is fully functional in all respects, and the only medications he takes is
Coumadin, be given medical certification to continue flying as a private pilot?
In my case, the surgery was performed in 1988 and I have no medical problems; I
run, lift weights, golf, etc. I have been previously told that the valve implants
are considered re-vascularization and therefore cause for disapproval of medical
clearance. Thank you! Bob
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Yes, through special issuance. The clotting factor blood tests
(pt and ptt) must be in accepted ranges... you will need a letter from
your cardiologist, lab tests, all your medical records, and any post-op
tests (such as echocardiograms, stress tests). Best of luck!
Dr. Roberts (SkyDoc)
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How often does the FAA issue 2nd class medical certificates to
airmen who have had sucessful angioplasty? Angioplasty with no
restenosis, good thallium treadmill, etc...Larry
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Yes, thru the special issuance process. As long as the
angioplasty worked and you are symptom-free you should get it.
Dr. Roberts (SkyDoc)
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I am a 58 year old male. As part of an annual in-depth physical exam, I recently had
a stress Ekg which showed an irregularity at a pulse rate of 170. A heart cath showed
a coronary artery 100% blocked, with the remaining coronary arteries 0-20% blocked.
The area served by the blocked artery was determined to be receiving adequate
blood flow from other arteries for all but the most taxing demands. The Doctor said
no corrective action was needed and that no additional threat to life resulted from
the blockage. He prescribed 180mg Diltiazem and a low fat diet. I am to go back for
a thallium ekg in one year. What do I need to do before exercising or renewing my
Class 2 physical??? Thanks, John
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John, You will need to submit a thallium stress test, a 12-lead EKG,
and a summary letter from your cardiologist, along with all of your
medical records. The FAA will then review your case for a special
issuance.
Dr. Roberts (SkyDoc)
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I have recently been diagnosed as having angina, and have been placed
on Procardia. How will this effect my medical?
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Angina precludes you from flying until you recieve a special issuance
from the FAA. You must send a summary letter from your cardiologist or
internist, a copy of your stress test, an EKG, and any other medical
records of treatment to Oklahoma City.
Dr. Roberts (SkyDoc)
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I have a skipped heart beat and my doctor tells me it is a premature
atrial contraction. What should I do?
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The FAA will require that you send to them a letter from your
treating doctor outlining the diagnosis, including whether it is
symptomatic or not, any medications you are taking, and a copy of your
treadmill test. You then will be eligible for a special issuance.
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Three years ago, I had a myocardial infarction. Blockage was found in right coronary
artery and treated with angioplasty. Last EKG treadmill was Completely Normal. My
LDL does need to come down. What can I do to increase the chance of a YES
answer by FAA on a Special Issuance?
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Submit a letter from your cardiologist outlining your
diagnosis, course of treatment, medications taken, and include a copy of
your last stress test. If you are on a diuretic, include a copy of your last
chemistry panel.
Dr. Roberts (SkyDoc)
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About a year ago, I had a heart attack. I have had heart surgery, and
am symptom free. What does the FAA want from me and my doctors?
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You will need to submit a summary letter from your cardiologist to
include the diagnosis, treatment course, response to treatment,
progosis, and medication taken (to include dose and frequency taken).
You will also need to submit your hospital medical records, a recent
thallium stress-test, and results from any other recent tests, to
include lab testing. This condition entails a special issuance by the
FAA.
Dr. Roberts (SkyDoc)
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Can a person who has a T-wave inversion have any chance of obtaining a class 1 medical. Ultrasound scan ok.
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Probably, yes. T-wave abnormalities, alone, may or may not be significant.
It largely depends on whether the T-wave inversion represents myocardial infarction (MI).
Dr. Roberts (SkyDoc)
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