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.
There are compact ECG/EKG devices that an individual can use occasionally to foresee problems, and doctor/EME can make more use of.
Kardia’s ‘6-lead’ one is notable, place it on knee and press with a finger of each hand. Uses smartphone, I’ve used it with recent Samsung and recent iPhone - for me it is a toy as my heart is good but pricey for that: a few hundred dollars.
Does not substitute for continuous monitoring.
And there’s:
Kardia claims equivalent of 6 leads, I guess because lab EKG uses three leads on each side of body.
“ Guide for Aviation Medical Examiners
Item 39. Anus
Anus exam (visual anal or digital rectal exam [DRE]) is not required unless indicated by past medical history (PMH) or symptoms. It may be performed at the discretion of the examiner and applicant.
What PMH warrant an examination of the anus? What are the pass/fail criteria for the anus?
Probably just the FAA’s way of sticking it to the man without actually showing any own effort or having to hire staff.
The deed needs to be done, please bend over.