A
Anon
Guest
Recently I was seen in the ED for palpitations. I was asymptomatic other than a fluttering in my chest. All lab work was normal and I was discharged to follow up with my primary care physician. My physician referred me to a cardiologist who did a stress test (non nuclear) to 85% MHR. The conclusion stated: “there were no symptoms during stress. There were isolated PVCs during stress. Decrease with exercise. There was a normal ST segment and hemodynamic response to stress.
He also did an echocardiogram which was normal and a 24 hour Holter which revealed about 200 PVCs and no other arrhythmias.
During a follow up appointment I told the cardiologist about a four day period in which I felt a subtle chest pressure continuously and unaffected by exercise. He said that my description was non-cardiac, but we discussed other diagnostics to rule out anything worse as I have a family history of heart disease. Grandparents, not parents or siblings.
He recommended a cardiac CT angiogram with calcium scoring. The impressions were:
Calcified plaque involving the left main coronary artery less than 50% luminal narrowing.
Multifocal areas of calcified and non calcified plaque involving the LAD beyond the first diagonal branch resulting in approximately 50% luminal narrowing.
Diminutive appearance of the circumflex artery.
Total calcium score of approximately 41.3 suggesting mild calcified CAD.
My cardiologist is choosing to treat the results with diet, exercise, and a statin. He says that no one would stent that level of narrowing.
My question and confusion is how this scenario fits into the special issuance scenario of the FAA. It seems to be a gray area in which the narrowing is too benign to warrant angioplasty or stenting, yet may be at or above a level of disease that would warrant a special issuance. I require a First Class Medical.
Medical HX: HTN treated with meds.
He also did an echocardiogram which was normal and a 24 hour Holter which revealed about 200 PVCs and no other arrhythmias.
During a follow up appointment I told the cardiologist about a four day period in which I felt a subtle chest pressure continuously and unaffected by exercise. He said that my description was non-cardiac, but we discussed other diagnostics to rule out anything worse as I have a family history of heart disease. Grandparents, not parents or siblings.
He recommended a cardiac CT angiogram with calcium scoring. The impressions were:
Calcified plaque involving the left main coronary artery less than 50% luminal narrowing.
Multifocal areas of calcified and non calcified plaque involving the LAD beyond the first diagonal branch resulting in approximately 50% luminal narrowing.
Diminutive appearance of the circumflex artery.
Total calcium score of approximately 41.3 suggesting mild calcified CAD.
My cardiologist is choosing to treat the results with diet, exercise, and a statin. He says that no one would stent that level of narrowing.
My question and confusion is how this scenario fits into the special issuance scenario of the FAA. It seems to be a gray area in which the narrowing is too benign to warrant angioplasty or stenting, yet may be at or above a level of disease that would warrant a special issuance. I require a First Class Medical.
Medical HX: HTN treated with meds.
