AASI for Coronary Heart Disease (CHD)

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AME Assisted Special Issuance (AASI) is a process that provides AMEs the ability to reissue an airman medical certificate to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations, (14 CFR) part 67.  This AASI is for an applicant with a history of Angina Pectoris; Atherectomy; Brachytherapy; Coronary Bypass Grafting; Myocardial Infarction; Percutaneous Transluminal Angioplasty (PTCA); Rotoblation; or Stent Insertion for any class.

The FAA physicians provide the initial certification decision and grant the Authorization for Special Issuance of a Medical Certificate (Authorization) in accordance with 14 CFR § 67.401.  The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the issuance determination.  If this is first-time application for an AASI for the above disease/condition, and the airman has all the requisite medical information necessary for a determination, you must defer and submit all of the documentation to the AMCD or your RFS for the initial determination. 

AMEs may reissue an airman medical certificate if the applicant provides the following:

• Authorization granted by the FAA;
• Coronary Heart Disease (CHD)/ Coronary Artery Disease (CAD) Recertification Status Summary (PDF) – Completed within the past 90 days.

The AME must defer medical certification if:

• Any item falls into the “NO*” column on the Coronary Heart Disease (CHD)/ Coronary Artery Disease (CAD) Recertification Status Summary (PDF) ;
• Any other disqualifying medical conditions or therapy not previously reported;
• Any other reason for not renewing an AASI;
• Bleeding that required medical intervention or other; 
• Chest pain - Complains of chest pain at any time (exclude chest pain with a firm diagnosis of non-cardiac causes of chest pain);
• New Event - Has another event, develops a new condition, or identification of an additional cardiac condition not previously reported (such as myocardial infarction or restenosis requiring CABG, atherectomy, brachytherapy, PTCA, stent, or other procedure);
• Nitrate - Is placed on a long acting nitrate for any reason; or
• Risk factors - Inadequately controlled.

NOTE: As of 05/29/24 - For routine cases, follow-up stress test is no longer required provided ALL items on the CHD/CAD Recertification Status Summary are in the “YES” column. If risk factors are not controlled, any significant interval history change, or any concerns, the AME must defer.