First class question

[Austin Taylor]

I had coarctation of aorta repair at the age of 1 with no complications since. I regularly see cardiologist and have yet to have an issue. I also take BP med’s but during my medical it was 125/75. The AME contacted the Atlanta office to see if they want me to do an EKG or visit a cardiologist again before he will grant my first class medical (initial). Is this normal? I was under the impression that AME’s were appointed to make these decisions, especially since the FAA is usually slow to respond to these things.

 

[TCABM]

I had a childhood ASD repair; my initial FAA physical required additional scrutiny due to that cardiac event.

Even if you have all the records and notes associated with the event and follow up, the FAA is likely to want a recent (defined as within 90 days) statement from a qualified physician. They may ask for any of a variety of tests be administered as well.

So no, it’s not unusual.

 

[Lindberg]

I had coarctation of aorta repair at the age of 1 with no complications since. I regularly see cardiologist and have yet to have an issue. I also take BP med’s but during my medical it was 125/75. The AME contacted the Atlanta office to see if they want me to do an EKG or visit a cardiologist again before he will grant my first class medical (initial). Is this normal? I was under the impression that AME’s were appointed to make these decisions, especially since the FAA is usually slow to respond to these things.

If the AME feels that your issue is not adequately addressed in the FAA's guidance, he may contact the regional flight surgeon for additional guidance. I've had that happen before, but it was after a consult. Did you have a consult or an actual exam? If an exam, the AME has 14 days to make a decision to issue or defer to the FAA. The AME is empowered to make decisions within their ambit, but some decisions must be deferred to the FAA. In addition, the FAA reviews the information from your exam even if the AME issues you a medical certificate, and they can request more information from you or, in extreme cases, revoke your certificate if they don't think the AME should have issued it. He may be trying to avoid that by getting in front of the RFS and making sure your ducks are in a row. But asking your AME what's going on will get you a more definitive answer than us speculating.

 

[Lindberg]

This might be helpful: https://www.faa.gov/about/office_or...e/guide/app_process/exam_tech/item36/amd/occ/

 

[TCABM]

This might be helpful: https://www.faa.gov/about/office_or...e/guide/app_process/exam_tech/item36/amd/occ/

Cliff notes version:

Decision Considerations - Aerospace Medical Dispositions
Item 36. Heart - Other Cardiac Conditions
The following conditions must be deferred:
….
13. Any other cardiac disorder not otherwise covered in this section.
14. Hypotension. A history of low blood pressure requires elaboration. If the Examiner is in doubt, it is usually better to defer issuance rather than to deny certification for such a history.

 

[Austin Taylor]

Update on this: AME deferred and my paperwork from the FAA is on its way. I set up an appointment with cardiologist already since finding appointments can take months these days. No idea what they will be requesting but if any of you have insight on this, please share! Thank you

 

[TCABM]

Update on this: AME deferred and my paperwork from the FAA is on its way. I set up an appointment with cardiologist already since finding appointments can take months these days. No idea what they will be requesting but if any of you have insight on this, please share! Thank you

You could ask your AME if he’s aware of what would be in the FAA letter. Unless your AME is the hands-off type and then, I guess you’re stuck waiting.

For my last FAA medical (with a 40-yr old history of ASD repair), the FAA requested a bubble echo and a Bruce stress test performed to the FAA’s spec, which a lot of labs seem to screw up on.

If you’re asked to do the stress test, you’ll need the trace copy of the ekg as the FAA will only accept originals, not black and white copies.

What you’re asked for may be wildly different.

 

[bbchien]

ASD repair:
Current Bubble Echo
EKG
Stress treadmill- since bundle branch blocks are common, you need a stress treadmill nuclear, though if you are without such blockade, a regular TM stress +/- stress echo should do.