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Thread: Heart Attack

  1. #1

    Heart Attack

    I recently had a mild heart attack with very minimal damage. I was
    not hospitalized and subsequently passed a treadmill stress test. Has
    anyone had a similar condition and how difficult was it to run the
    traps with the FAA or are my flying days over?


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  2. #2
    Orbiting Earth Orbiting Earth Smithy's Avatar
    Join Date
    Apr 2007
    Werribee, Victoria, Australia
    Whilst not being 100% sure about the FAA's medical regs I know the US and Australia accept each others medicals so I assume the requirements are similar.
    You'll need to show that the AMI (heart attack) didn't cause any functional wall damage and this is shown by a combination of the extent of the tropinin rise post infarct and a cardiac ultrasound to show if there is any change in wall motion or valve function. Troponins are an enzyme that are released as cardiac muscle dies..The higher the level the more damage being done.
    I'd be interested to know how a heart attack was diagnosed if you weren't hospitalized. What were you doing when the incidence of chest pain took place? How did it resolve. Are you a smoker, overweight, and do you have a family history of heart disease? Is it the first time you've felt any chest discomfort? Was there a change in your ECG during or after your bout of chest pain? Were serial enzymes taken? If you were on a 12 lead ECG which leads were involved in any changes?
    These are all questions an FAA medical examiner will ask.
    Having a negative exercise test is a good start but it doesn't necessarily rule out a blocked artery. I imagine to be re certified you'd need an extensive cardiac workup under an aviation cardiologist and he'd be the one recommending to the FAA that your privileges as a pilot be reinstated. For your own good thats what you need.
    If you satisfy him that your risk of further problems is low you'll be re certified, though if its anything like Australia there will be a six month wait until you can apply. In that time take a good look at your lifestyle. Are you overweight? If so lose it. Smoker? Quit. Whats your cholesterol doing..Not just total number but HDL/LDL ratios. You have to show that you mean business in getting yourself healthy enough to be trusted with an aeroplane.
    A mild heart attack is a warning...Heck it may have just been a bad angina attack. But that still shows things arent working as they should. Without an angiogram you dont know what other coronary arteries may be diseased.

    Sorry for seeming to be a harbinger of doom but this is a wake up call....I've seen it all too many times....


  3. #3
    Jim: I've been flying under a "Special Issuance" third class medical for about fifteen years now and the processes for jumping through those hoops are all about the same. Although I never had a heart attack, I have been found with other heart related issues. The FAA requires the OK to proceed from your flight surgeon and you will need to send all the initial data to the FAA for them to chew on. I think that with a heart attack you must wait (without complications) at least 6 months after the event before you can apply for the special issuance. The APOA has a medical section on their web site where you can get the details relative to a heart attack. For me, I have to take a tredmill test and blood work annually and send in my application (now for an established Special Issuance applicant, the flight surgeon can issue the certificate). It will take one to four months for the FAA in Oklahoma to approve your special issuance. After the first time, the application process will be closer to the 1-2 months. As I get a little older, I find more airmen my age operating under a special issuance third class medical. Good luck with the process.


    P.S. Special Issuance medicals are good for no more than 12 months (sometimes shorter).

  4. #4
    Orbiting Earth Orbiting Earth Smithy's Avatar
    Join Date
    Apr 2007
    Werribee, Victoria, Australia
    Just out of curiosity what does a special issuance medical allow you to do? Over here a 3rd class medical only applies to Air traffic controllers. The bare minimum to fly as PIC is a second class medical which if you've had any form of heart attack no matter how mild requires everything I said above. In serious cases you can get a waiver stating "and or with co-pilot" meaning solo flight is out of the question on a VH registered aircraft. You can however fly an ultralight (think Spacewalker, Flybaby, Skyfox) without a medical as they dont come under the control of our govt authority.
    However provided you meet the criteria post infarct the crux of which is the ability to pass a stress ECG to the Bruce protocol which is achieving 85% of your age related peak heart rate unmedicated without any changes to your ECG, as well as having no functional wall abnormality or significant murmers then you should be alright. But it is important as I said before to demonstrate that the lifestyle that led you to this point changes significantly. If your aviation medico sees that you still smoke 20 a day while munching on that bacon double cheeseburger I doubt he'll be inclined to take the risk on you if you've had heart trouble since if you have a disabling event in the air its on his shoulders and given that your society sues for tripping over your shoe laces I think he'll like to protect that nice house and the new Bonanza he just bought!
    I'm saying this to everyone on this list. Once you have trouble with your medical its a nightmare to get it back. So look after yourselves.
    Lesson over.

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