Aerospace Medical Dispositions
These are the most common heart conditions of aeromedical significance.
AMEs will not immediately issue medical certificates if there are heart conditions that require deferral, or for any other cardiac condition that may result in sudden or subtle incapacitation. This is includes the nebulous category of "Angina Pectorus," a term referred to ischemic chest pain resulting from insufficient cardic perfusion. Angina can be stable or unstable--unfortunately both require cardiology work up and are disqualifying until the coronary vessel status is fully evaluated. If the airman has one of these conditions, then the AME will consult with the FAA (AMCD) or the Regional Flight Surgeon. Medical documentation must be submitted for any of these cardiac conditions to support a possible waiver (special issuance) of an airman medical certificate.
Cardiac Work Up FAQ's:
Unfortunately cardiac disease is very common among pilots and controllers, and airman should seek early treatment to avoid medical complications and disability. Your health comes first, but we realize your aviation career (professional or hobby) is a close second! The FAA routinely waivers adequately treated heart disease, so don't hide these issues from your AME for fear of permanent grounding. Pilots and controllers who optimize their health also optimize their chances for FAA medical certification. Find an AME.
There are many types of heart problems, and all are significant to aviators. ALPA reports that 23% of almost 10,000 pilots contacting their office each year do so for cardiovascular disease. If your doctor tells you about a heart problems, or you suspect symptoms, don't take immediate dispair! The FAA granted nearly 6,500 Special Issuance Authorizations/SIA (waivers) for pilots with coronary artery disease in 1997. Of these, most were for coronary artery disease or heart attacks (myocardial infarctions). The majority of these pilots were treated with bypass grafting, angioplasty and/or intracoronary artery stents. The FAA granted 509 waivers for First Class, 512 for Second Class and 5,555 were for Third Class Certificates. Pilots with heart valve replacements, rhythm disturbances, pacemakers and heart failure were also granted waivers. According to Virtual Flight Surgeons, only 0.1% of medical applications to the FAA receive a final denial.
As with all medical problems, you should try to learn as much about the subject as possible, but FlightPhysical.com strongly recommends that you find an AME to help coach you through the relevant considerations and work-up required for your particular situation. As mentioned, thousands of pilots have had heart problems, and with patience and persistence, it may be possible to climb back into the cockpit. For your and the public's safety, there is a well-defined path which must be followed prior to strapping back in the front seat. This page is an index to various cardiac conditions for which the FAA has devised pilot protocols.