Guide for Aviation Medical Examiners
Decision Considerations - Aerospace Medical Dispositions
Item 36. Heart - Other Cardiac Conditions
The following conditions must be deferred:
- Cardiac Transplant - see Disease Protocols
- Cardiac decompensation
- Congenital heart disease accompanied by cardiac enlargement, ECG abnormality, or evidence of inadequate oxygenation
- Hypertrophy or dilatation of the heart as evidenced by clinical examination and supported by diagnostic studies
- Pericarditis, endocarditis, or myocarditis
- When cardiac enlargement or other evidence of cardiovascular abnormality is found, the decision is deferred to AMCD or RFS. If the applicant wishes further consideration, a consultation will be required "preferably" from the applicant�s treating physician. It must include a narrative report of evaluation and be accompanied by an ECG with report and appropriate laboratory test results which may include, as appropriate, 24-hour Holter monitoring, thyroid function studies, ECHO, and an assessment of coronary artery status. The report and accompanying materials should be forwarded to the AMCD or RFS.
- Anti-tachycardia devices or implantable defibrillators
- With the possible exceptions of aspirin and dipyridamole taken for their effect on blood platelets, the use of anticoagulants or other drugs for treatment or prophylaxis of fibrillation may preclude medical certification
- A history of cardioversion or drug treatment, per se, does not rule out certification. A current, complete cardiovascular evaluation will be required. A 3-month observation period must elapse after the procedure before consideration for certification
- Any other cardiac disorder not otherwise covered in this section
- For all classes, certification decisions will be based on the applicant's medical history and current clinical findings. Certification is unlikely unless the information is highly favorable to the applicant. Evidence of extensive multi-vessel disease, impaired cardiac functioning, precarious coronary circulation, etc., will preclude certification. Before an applicant undergoes coronary angiography, it is recommended that all records and the report of a current cardiovascular evaluation, including a maximal electrocardiographic exercise stress test, be submitted to the FAA for preliminary review. Based upon this information, it may be possible to advise an applicant of the likelihood of favorable consideration.
- A history of low blood pressure requires elaboration. If the Examiner is in doubt, it is usually better to defer issuance rather than to deny certification for such a history.