The Federal Aviation Administration updated its Guide for Aviation Medical Examiners on Wednesday, adding several cardiac-condition disposition tables for pilots and air traffic control specialists seeking medical certification.
The update applies to Item 36, Heart, and includes new tables for heart murmur, congenital heart conditions, endocarditis, Wolff-Parkinson-White and other pre-excitation conditions, fibromuscular dysplasia, heart transplant and hypertrophic cardiomyopathy. FAA archives also list updated murmur examination guidance, a new link to medication guidance and several related administrative changes.
The new tables outline when an Aviation Medical Examiner may issue a certificate and when the case must be deferred to the FAA for possible special issuance. Some low-grade or nonpathologic heart murmurs and certain uncomplicated patent foramen ovale findings can be issued by the AME when there are no symptoms that would interfere with flight duties.
For other conditions, the tables generally call for FAA review. Common requirements include a current detailed clinical progress note, an echocardiogram, cardiac monitoring and additional records or testing depending on the condition. The heart transplant table includes separate guidance for first- and second-class applicants, air traffic control specialists and third-class medical applicants.
Several of the new tables also specify time windows for supporting medical information. In many cases, clinical notes, echocardiograms and cardiac monitoring must be completed no more than 90 days before the AME exam. For pilots, the changes provide a more specific FAA pathway for several heart-related medical histories that previously fell under broader cardiac guidance.
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