The two main reasons for performing an EKG on an airman are the requirement for first class airmen when he turns age 40, and every year after; and for the initial packet when a pilot is reporting for the first time treatment for high blood pressure. It is the responsibility of the AME to interpret the EKG and, if it is abnormal, to have you undergo certain testing and evaluations to make sure you have no underlying medical condition.
If the AME is uncomfortable reading the EKG, he or she should have it interpreted before they release you from the office with a medical certificate in hand. Most EKG machines these days have self-interpretation capability, and the FAA has given AMEs a list of “normal variants.” These are findings on electrocardiograms that have been found not to be aeromedically significant.
When you have an ECG performed in your AME’s office or bring one in from your own treating physician, it is critical to ask the AME how it looks. If he or she says that it is not normal, you need to press them about obtaining more testing to demonstrate to the FAA that you are OK. Do not leave the office until you both agree on a next step to establish that you are OK. If the AME does not review the EKG and is not “negative,” some months later you may receive one of those letters that say that your electrocardiogram shows a variance and you need to provide the FAA with testing. If that happens then I strongly suggest that you find yourself another AME!
For more expert advice and professional assistance with protecting your pilot and medical certificates year-round, visit—and consider joining—AOPA Pilot Protection Services.
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