Heart and Circulatory Conditions

Part 67 of the Code of Federal Regulations (14 FCR 67) explains the certification procedures and medical standards for issuing medical certificates for pilots. The FAA considers several medical conditions as disqualifying for pilot certification. 

Those conditions include: 

  • Epilepsy
  • Angina pectoris
  • Diabetes mellitus that requires hypoglycemic medications
  • Myocardial infarction
  • Substance dependence and abuse
  • Bipolar disease
  • Permanent cardiac pacemaker
  • Loss of consciousness without an explanation of the cause
  • Coronary heart disease
  • Heart replacement
  • Psychosis
  • Cardiac valve replacement
  • Transient loss of control of nervous system functions without a known cause
  • Personality disorder severe enough to result in repeated overt acts

Other conditions could also disqualify a pilot from operating an aircraft. Therefore, this list is not exhaustive, and each case is reviewed based on its facts and circumstances.

Heart and circulatory conditions are scrutinized when certifying a pilot to fly. Several of the conditions that disqualify a pilot are related to cardiovascular issues.

What Is a Heart Attack and Why Is the FAA Concerned?

A myocardial infarction or heart attack happens when the heart does not receive sufficient oxygen. A common cause of heart attacks is coronary artery disease, a lack of sufficient oxygen because of a blockage of one or more arteries carrying oxygen to the heart.

The FAA is concerned that a heart condition could cause a heart attack mid-flight. If the pilot suffers a heart attack, they could lose control of the aircraft. They could go into full cardiac arrest, resulting in unconsciousness and death.

Can I Fly Again After a Heart Attack?

The FAA carefully considers a pilot’s health conditions before certifying them to fly. A massive heart attack disqualifies a pilot from flying. But, it does not mean that the pilot cannot obtain their medical certification after they recover and their heart condition is treated.

However, the underlying cause of the heart attack could be a problem. Coronary heart disease (CHD) is the common cause of most heart attacks. Even when CHD is treated, there could be symptoms and complications that could disqualify a pilot from flying. The list of disqualifying conditions also includes two conditions of untreated coronary heart disease: myocardial infarction and angina pectoris.

If you have a heart attack, obtaining your FAA medical certificate can take a lot of time and effort. The FAA will require you to meet very specific conditions before you can be certified to fly after a heart attack. 

Those conditions include:

  • Be symptom-free of CHD, which means no signs of coronary heart disease, such as shortness of breath and chest pain
  • Submission of all relevant medical records related to your diagnosis of a heart or circulatory condition, including the treatment you received and are currently receiving
  • Pass a graded exercise stress (GXT) test that meets FAA standards
  • A current status report and current cardiovascular evaluation from your treating physician

If you are applying for an unrestricted second-class or a first-class certificate, a GXT and cardiac catheterization must be repeated three to six months after your initial treatment. The FAA will carefully examine your medical records and other evidence to determine your current condition and whether you follow your doctor’s advice regarding diet, medication, and exercise.

Obtaining an FAA medical certificate after a heart attack can depend as much on your condition as the application you submit after your recovery. Working with an experienced aviation attorney is strongly recommended. An FAA medical lawyer understands the requirements for certification and the medical application process.

Heart and Circulatory Conditions – Applying for FAA Medical Certification

The FAA has detailed specifications to determine if a pilot is eligible for certification if they currently have or have had a history of circulatory conditions or have had a heart attack. The cardiovascular evaluation is thorough and must contain sufficient detail to permit an objective and clear assessment of the pilot’s degree of functional capacity, recovery, and prognosis.

It is best for a physician specializing in cardiology or internal medicine to perform the evaluation. A doctor with specific knowledge of the FAA’s specifications for a cardiovascular evaluation is also helpful.

At a minimum, the FAA requires that your cardiovascular evaluation include:

Your Medical History

A complete medical history is required to be certified to fly. However, if you have a heart condition or circulatory problems, your medical history must include details regarding any cardiovascular abnormalities. It should explain the condition and whether medications or other treatments are currently being used, including the specifics about each of the treatments or medications.

Family Medical History

In addition to your medical history, the evaluation must include information about close family members with heart or cardiovascular conditions. You must indicate the relationship to you and the age at which the person was diagnosed with the condition. You are required to disclose if close blood relatives have had or currently have hypertension, heart attacks, and other known lipid metabolism disorders.

Social and Personal History

The evaluation also includes information about your social and personal activities, such as drinking, smoking, and recreational habits. You must indicate whether you participate in a program to maintain your physical fitness, such as an exercise routine. Information about your occupational pursuits, functional limitations, and level of physical activities must also be included.

All Relevant Medical Records

The application must include all medical records, including hospital records and treatment as an outpatient. The records should consist of clinical data from laboratory work, X-rays, ECG tracings, and other diagnostic studies. The records should also include detailed reports of all surgical procedures.

Current Physical Condition

The physician must perform a general physical examination. The report should briefly describe relevant personal characteristics and data gathered during the examination. Particular interest is given to the results of tests and procedures to examine your current heart and cardiovascular health.

Laboratory Data

The doctor will order numerous tests for the evaluation, including fasting blood sugar, serum cholesterol, triglycerides, and other blood chemistries.

The above information is a broad discussion of what is required for FAA medical certification after a heart attack or diagnosis of a circulatory condition. If you’ve had a heart attack, the FAA will require a mandatory observation period. The duration of the observation period depends on whether you have had a heart attack and the details of your coronary artery disease.

Get Help From an FAA Medical Defense Attorney

If you are concerned about how your heart and circulatory conditions impact your employment, contact the attorneys from The Ison Law Firm Aviation Lawyers for a free consultation with an aviation attorney at (855) 322-1215

Working with an attorney before applying for an FAA medical certificate is the best way to plan how to present your case to your AME or the FAA. We represent clients nationwide regarding FAA medical certification and other aviation matters.