1st time Class 3 medical with PACs

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Schrödinger's duck

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I’m looking to get a Class 3 medical for my private pilot license. Here’s the situation: last spring I saw a cardiologist because I was having heart palpitations that would last for hours and, a couple of times, made me feel lightheaded. My at-home Kardia device showed supraventricular ectopy. That said, the cardiologist ran a full workup and found everything to be normal. My Progress records say:
  1. I was diagnosed with mitral valve prolapse as a child, but my current echo cardiogram shows no prolapse and no structural abnormalities.
  2. I wore a 7-day Holter monitor — PACs < 1%, PVCs 0%. The outcome was “no arrhythmias.”
  3. Bruce protocol stress test — 12 minutes (METs 13.4), bpm from 93 to 193, PVCs in recovery
  4. My primary care physician noted that I do not experience syncope but described symptoms suggestive of orthostatic hypotension, like feeling lightheaded when standing up quickly (I actually never reported that).
  5. She also documented intermittent episodes of lightheadedness and palpitations — which is accurate.
  6. Cardiologist wrote: The patient overall endorsed dizziness on exertion and episodic lightheadedness
  7. Lipid panel LDL showed 124
By the time I actually saw the cardiologist, the symptoms had resolved. Over the summer I went mountaineering and ran my first half marathon in 2:30, which makes me feel like I’m clearly not on the verge of cardiac collapse — but I’m not sure how an AME will view it.

I’m a 39-year-old female and trying to decide what to do. I don’t want to complicate things right out of the gate. Should I go ahead and apply for the Class 3 medical, or play it safe and pursue a Sport Pilot certificate instead?
 
Schrödinger's duck said:
I'm a 39-year-old female and trying to decide what to do. I don’t want to complicate things right out of the gate. Should I go ahead and apply for the Class 3 medical, or play it safe and pursue a Sport Pilot certificate instead?
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The answer to this question depends on what you want to do in aviation. If you want to go beyond PPL and get into instrument/commercial flying, you'll need to get the Class 3 medical. Scheduling a CONSULT with an AME to discuss your situation before actually filling anything out in MedXpress is the way to go. On the other hand, if your flying is going to be recreational sunny-day flying, you can probably just fly under Sport pilot privileges which, with the recent MOSAIC improvements, meet the flying needs of most recreational pilots.
 
Never had Covid, received 2 doses of the mRNA vaccine though in 2022. I don’t think it is related. Looks like I’m not on that arrhythmias list because nothing was registered by the cardiologist.
 
...and no diagnosis of atypical migraine (I'm not kidding- lightheadedness, might = atypical vascular headache....gets better with low dose verapamil and propranolol....we CACI that)

The FAA yawns at up to ~28% of beats being VPCs if the Echo is normal, but given no history of anyone thinking atypical migraine may lead to the FAA calling it "Palpitations" But if you are on no meds, I think they will yawn.

The special for Palpitations is very very easy- just a letter from the cardiologist once a year.
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Thanks Dr Chien for the information. I don’t have any headaches, not on any meds. Lightheadedness happened a couple of times, very minimal. I hope they won’t defer, I don’t want any delays taking several months. I will be out of flying season in this case I regret going to the doctor with that issue. I thought it might be something serious that can cause heart enlargement in the future or other serious problems. They didn’t help me anyway, and it resolved on its own but now there’s this record. I will try to find an AME who can do a consultation first before submitting anything.
 
Hi all, just want to share the update here. Got my medical certificate today :cheers: I did it the way people suggested here. Got Progress Records from my primary physician and cardiologist, then scheduled a consultation with an AME. He said everything looks really good. After that I scheduled my exam and walked out with the certificate in my hands :)
 
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