Irregular Heartbeat and FAA medical

[ultrarunner]

A friend of mine told me today that he has this condition. This is the first time he has experienced it. His father has this condition, as did his grandmother.

He has a good doc, and is going in for some tests, a treadmill stress test, etc...

I have also referred him to someone who is an AME specializing in "...tough cases...." Depending upon the severity, is he facing any trouble in maintaining a first class medical?

thanks

 

[bobbysamd]

FAA medical woes

Has your friend applied yet for his medical? The AME might issue it to him on the spot without further examination. On the other hand, the doctor may not pending receipt of reams of documentation. Your friend may need to submit update reports by his cardiologist, internist, etc. to the FAA to maintain his medical. A letter from the specialist is usually all that's needed for each exam.

www.leftseat.com is an excellent FAA medical website.

A better idea for your friend is for him to discuss his situation with an AOPA counselor. The advice is great, and confidential.

 

[ultrarunner]

My friend currently holds a valid first class medical. This condition of his was not discovered by a doc during an exam, but by himself. He felt, it was that pronounced he told me. He then subseqently has visited his FAA doc, and more tests are sched. as I previously mentioned. He told me his current first class is good thru end of Oct at which point it's a second class for 6 more months. His current job requires the latter. His faa doc is also his primary car doc. He is still currently flying.

 

[RockyMnt1]

Ummmm... Your friend is officially grounded as of
now even if his medical does not expire for awhile. Check the FARs. I have just been down this little trail (except with cancer). Irregular heartbeat is a disqualifying condition without supporting documentation. This person's medical condition has changed thus making his medical invalid until a waiver is issued by the Administrator.

As hard as it is, he should do it the right way
for the sake of his passengers and the rest of us flying in the same airspace. It can be handled above board. I have a friend who underwent a quadruple heart bypass. He now has a 1st class medical. I got mine back after supplying documentation. Not really any hastles.

 

[aggiepilot87]

His faa doc is also his primary car doc.

IMVHO, don't mix FAA and your regular doctor. Should someone develop a problem, it may be helpful to work on the issue with your primary care provider before discussing with the FAA doctor - should you choose to do so. With these two people in the same shoes, you've lost this option. BTW, please don't lecture on reporting medical issues. I'm aware of the consequences.

Also, WRT the irregular heartbeat, I'm not an MD, so take this for what it's worth. Have your buddy look at his lifestyle - excessive stress, caffeine(!), sleep, bad diet, too little exercise can have immediate effects. It's amazing how much these can affect your health, and cause irregular heatbeats. I've got a "friend" who also had irregular heartbeats. Long story short, it was 90% caffeine and the rest diet, sleep and stress. A little lifestyle change and it's no longer a problem whatsoever.

Sounds like your friend has already talked with the dr. Until he gets some of the tests done, he may want to work on the caffeine, stress, etc. It *might* solve his problem.

Good luck with the issue.

 

[bobbysamd]

Gulp!!!

One should never use the FAA doc as one's primary care physician. An FAA AME is the FAA's industrial physician. He is not your buddyroo. An AME is looking out for the FAA's interests and is very much an arm of the FAA's bureaucracy. There is an inherent conflict of interest if your regular doctor is also your AME.

If anyone is at all familiar with the Workers' Compensation system, compare an AME to the Workers' Comp doc. W.C. provides only minimal care because its providers are beholden to the insurance company and not to the patient. W.C. doctors routinely state that many workers who've been injured on the job have not suffered disability (impairment) when independent medical examinations (second opinions) prove they have. Get the picture?

Get a private physician who is in no way affiliated with the FAA. Your own doctor is beholden to your interests.

Once again, get informed advice. I've heard of people who've had heart attacks who are flying after jumping through the FAA's manifold hoops. It used to be that a coronary was automatically disqualifying. Therefore, if the FAA lets people who've had heart attacks fly, getting clearance to fly with an irregular heartbeat is possible, too.

Best of luck to our original poster's friend.

 

[RockyMnt1]

Irregular Heartbeat and FAA Medical

aggiepilot87,

From your reply, I assume that you are in a similar medical situation. I certainly didn't mean to lecture, but there may be other folks who may be "on the fence" with this issue that could benefit from the information. I know it kind of strikes a nerve when dealing with the subject. Keep in mind that I am not directing this at you personally, but rather for the benfit of all of the forum participants.

One other point and then I'll quit. Since the FAA and personal doc are one in the same, should something happen that would require an investigation, medical records will be obtained. This would put the pilot's personal estate and assets at risk from possible lawsuits. I don't think that many of us can afford that kind of exposure given that recent amounts of jury awards. Just food for thought.

Good luck to everyone one in this situation.

 

[ms6073]

Well I am certainly not an M.D. but having been diagnosed as being asymptomatic for Wolf Parkinson White syndrome (WPW) while in the military, I think a quick review of the 1st calss medical cardiovascular medical standards are in order:

Cardiovascular standards for a first-class airman medical certificate are:

(a) No established medical history or clinical diagnosis of any of the following:

(1) Myocardial infarction;

(2) Angina pectoris;

(3) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;

(4) Cardiac valve replacement;

(5) Permanent cardiac pacemaker implantation; or

(6) Heart replacement;

From that, it seems that as long as the original posters 'friend' is not diagnosed with any of the above maladies or afflictions, then there should be no problems concering the issuance and maintenance of a 1st class medical.

The American Heart Association says on its website that arrhythmias, disorders of the regular rhythmic beating of the heart, are common -- in fact, as many as 2 million Americans are living with atrial fibrillation (one type of rhythm problem). Arrhythmias can occur in a healthy heart and are often times of minimal consequence. Of course all things not being equal concerning our friends at the Aeromedical branch, appropriate measures should be taken to document the propblem.

 

[ultrarunner]

Hmmm, then if you continue to read 61.111 (b) it says:

"A person applying for first-class medical certification must demonstrate an absence of myocardial infarction and other clinically significant abnormality on electrocardiographic examination....."

Would you argue that since he's not applying for a medical he can skate on 61.111 (b), or that his diagnosis is not a significat abnormality????

In any event, I am surprised that his AME/PCP told him to keep flying. I fly with this person, and have asked him to get a difinitive answer before we fly together. And that he seek out the advice of some of the source previously mentioned.

thanks for all the replies.

 

[aggiepilot87]

Re: Irregular Heartbeat and FAA Medical

Originally posted by RockyMnt1

From your reply, I assume that you are in a similar medical situation.

No. But I have very good, accurate info on the effects of stress and caffeine on heart beat irregularity.

I certainly didn't mean to lecture, but there may be other folks who may be "on the fence" with this issue that could benefit from the information. I know it kind of strikes a nerve when dealing with the subject. Keep in mind that I am not directing this at you personally, but rather for the benfit of all of the forum participants.

sorry, but you've lost me. reask the question or restate your point. You wanting me to discuss the issue more? Guess I'm a little slow this morning.

One other point and then I'll quit. Since the FAA and personal doc are one in the same, should something happen that would require an investigation, medical records will be obtained. This would put the pilot's personal estate and assets at risk from possible lawsuits. I don't think that many of us can afford that kind of exposure given that recent amounts of jury awards. Just food for thought.

guess I'm not following this one either. You saying a pilot has a problem, his personal and FAA doc are the same,... so how'd we get to lawsuits at this point in time. You mean the pilot get's his medical suspended/yanked and keeps flying commercially anyway? That's kind of like flying drunk or out of currency... it would be illegal, and I guess a person could probably be sued also.

 

[ms6073]

Hmmm, then if you continue to read 61.111 (b) it says:

"A person applying for first-class medical certification must demonstrate an absence of myocardial infarction and other clinically significant abnormality on electrocardiographic examination....."

Would you argue that since he's not applying for a medical he can skate on 61.111 (b), or that his diagnosis is not a significat abnormality????

I think it also says that in 67.111:

(3) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;

Oops, I dont recall that you specified if this was a clinically significant abnormality during the initial post so I appologize if my post came across as an attempt to contradict. In my own experience, even though I had to be waivered for flight and parachute status while I was in the military, it has been a non-issue in that there was never even a mention of it during any EKG's for my FAA medical! I imagine that should my condition ever become symptomatic, then things will get complicated for me also.

 

[RockyMnt1]

ultrarunner,

That sounds like a prudent approach to take.

aggiepilot87,

Let's see if I can clear up some of the muddy waters that I created.

Point #1

Good suggestion on the caffeine/life style effects. I hadn't thought of that route. I hope that that is all it is!!!

Point #2

"BTW, please don't lecture on reporting medical issues"

The point that I was trying to make was that, to you, it might seem like lecturing about when a pilot should/shouldn't fly due to medical reasons. To others, it is new and valuable information. You need to realize that there are pilots spanning the whole spectrum (from students to ATPs) reading this forum.

Point #3

A pilot flying commercial activities during a period with a known (or even a questionable) medical disqualification would easily fall into the FAA catch all category of careless and reckless operation if not other categories (Not a lecture, infomational for other folks). If an accident were to happen during this time, the medical records would not be difficult to obtain because the FAA ME and personal doctor were the same person. Dates and notes of visits would verify that the pilot knew (or suspected) that there was a problem, but he/she continued to fly anyway. The safe thing to do would be to ground oneself until the cause was determined or the condition improved. It wouldn't be a large leap for a lawyer to convince a jury that the pilot had a willful disreguard for the wellfare of his passengers (and/or was responsible for the damaged caused) and was liable for the results.

 

[mooneydvr]

Tell your friend to go look at http://www.virtualfs.com/. They have lots of info for irregular heartbeats. One thing is clear. Go to an AME that knows what he is doing when it comes to supplying required tests to the FAA. I was diagnosed with a 1st degree AV Block. My current AME didn't know what to do with it and I lost my medical for a couple of months. It took finding an AME who was also a cardiologist to get it straight. He was pissed that the FAA was putting us through so much trouble over an AV block (a pretty benign condition).

MS6073 is right. Skipped beats are very common. It is not suprising that the AME told him to keep flying. Additional tests would not be indicated by even multiple occasional instances of skipped beats. There would need to be other symptoms before further tests would be needed which could include tight or pain in the chest, shortness of breath, and so on.

Good luck