Heart and Circulatory System

The FAA has amended the required observation and recovery time for applicants who have had coronary artery disease treated with uncomplicated Percutaneous Transluminal Coronary Angioplasty (PTCA) with stent placement. For First and Second Class cardiac special issuances, a three-month or six-month recovery and stabilization period is now required. For Third Class cardiac special issuance consideration, in accordance with BasicMed regulations FAR Part 68, the 90- or 180-day observation and recovery period is no longer required. See details below.

The requirements now include:

3rd class medical certification-Heart Attack and/or Stent:

A current cardiovascular evaluation that must include:

• Hospital Admission History and Physical report;
• Hospital Operative report;
• Hospital Discharge summary;
• All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
• Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides
  • A comment regarding your medication, the dosage, and frequency of use
• A maximum exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III  (9 minutes) of the 12-lead Bruce protocol.

1st and Unlimited 2nd* Class Medical Certification-Stent:

A current (within preceding 90 days) cardiovascular evaluation that must include:

• Hospital Admission History and Physical report;
• Hospital Operative report;
• Hospital Discharge summary;
• All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
• Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides
  • A statement regarding your medication dosage and frequency of use
• A three-month post event coronary angiogram including catheterization films, reports, and line drawings of coronary anatomy;
• A maximum radionuclide exercise stress test with complete tracings of the exercise portion of the test and radiographic images of the nuclear scans (Performed no sooner than three months after the stent procedure).

*An unlimited second-class medical has no functional limitations. A limited second-class medical may be issued, sometimes without the need for repeat coronary angiography, to pilots who need limited commercial privileges; however, a nuclear exercise treadmill test will be required for limited second class consideration. The limitations usually include "Not valid for carrying passengers or cargo for compensation or hire," "Not valid for PIC," or "Valid only when serving as a pilot member of a fully qualified two pilot crew." A limited second class also allows full third class privileges.

Coronary Artery Bypass Grafting:

Six months of observation and recovery is still required for Class 1 and 2 if treatment included coronary artery bypass surgery with open revascularization using cardio-pulmonary bypass.

A current (within preceding 90 days) cardiovascular evaluation that must include:

• Hospital Admission History and Physical report;
• Hospital Operative report;
• Hospital Discharge summary;
• All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
• Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides
  • A statement regarding your medication dosage and frequency of use
• 3rd Class - A maximum exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III (9 minutes) of the 12-lead Bruce protocol.
• 1st and Unlimited 2nd Class - a six month post event coronary angiogram and a maximum nuclear exercise treadmill stress test is required for initial consideration after bypass surgery. (Performed no sooner than six months after the bypass surgery).
  
  

Left Main Coronary Artery (LMCA) Stenting

For Class 1 and 2, a stent to the left main coronary artery requires six months of recovery.

3rd Class Medical Certification (LMCA):

A current cardiovascular evaluation that must include:

• Hospital Admission History and Physical report;
• Hospital Operative report;
• Hospital Discharge summary;
• All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
• Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides
  • A statement regarding your medication dosage and frequency of use
• A maximum exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III (9 minutes) of the 12-lead Bruce protocol.

1st and 2nd Class Medical Certification (LMCA):

A current (within preceding 90 days) cardiovascular evaluation that must include:

• Hospital Admission History and Physical report;
• Hospital Operative report;
• Hospital Discharge summary;
• All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
• Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides
  • A statement regarding your medication dosage and frequency of use
• A maximum radionuclide exercise stress test with complete tracings of the exercise portion of the test and radiographic images of the nuclear scans. (Performed no sooner than six months after the stent procedure).
• A post-event coronary angiogram will be required at least six months after the stent procedure.

How/Where to Submit to the FAA

Helps you find the contact information for submitting your medical records.

Updated 09/19