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NRCME DOT Questions and Answers
CAD
Ans: At least annual examination, and be on board with cardiology,
tolerate and comply with meds. No need to disqualify right away.
Acceptable Echo -
LVEF >/= 40%
Pulmonary artery pressure <50% systemic systolic BP.
Acceptable exercise tolerance -
Achieve >6 mets through Bruce stage 2 or equivalent (medium work up
to 50 lb carrying)
Attain HR of >/=85% predicted maximum unless on beta blockers
Rise in systolic BP >/= 20 mm/hg without angina.
No ST segment depression
Post MI
Ans: drivers must wait 2 months minimum. 1 year maximum.
Must be asymptomatic.
Tolerate meds
Acceptable ETT after the MI, and biennial after that
LVEF >/=40 (REQUIRES ECHO)
Needs cardiology clearance
Angina -
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Ans: Needs 3 month wait after angina.
Maximum of 1 year certification
Biennial ETT (Q2Y)
Cardiology clearance
Clearly delineate cardiac cause vs other cause. If this is transient and
noncardiac, treat the patient as if they do not have a condition. Not all
chest pain is cardiac angina.
CABG -
Ans: Sternum must be completely healed after this.
Minimum 3 month return
Maximum 1 year certification.
Annual ETT
Cardiology clearance.
PCI -
Ans: 1 week waiting time.
Maximum of 1 year clearance.
Cardiology clearance.
Biennial ETT
Pacemakers
Ans: Minimum 1 month wait if sinus node dysfunction / AV block
Minimum 3 month wait if hypersensitive carotid sinus with syncope
Maximum cert of 1 year
Needs routine pacemaker checks. Patient needs documentation.
SVT
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Ans: Minimum 1 month wait on anticoagulation and asymptomatic
1 month wait post isthmus ablation and diagnosis is atrial flutter
1 month wait if asymptomatic if AV reentrant tachycardia, WPW, atrial
tachycardia, junctional tachycardia
Maximum certification of 1 year.
Cardiology clearance + Annual cardiology visit.
Ventricular arrhythmias
Ans: Minimum 1 month wait if coronary heart disease, RV outflow V-
tach, Idiopathic LV V-tach
Maximum 1 year cert.
Cannot be sustained, nonsustained requires LVEF >/=40%
CANNOT CERTIFY hypertrophic cardiomyopathy, Long QT, Brugada
Heart Failure
Ans: Use NYHA classes (Only certify class 1)
Maximum 1 year certification.
Syncope
Ans: Requires a 3 month waiting period.
Maximum cert of 1 year.
Ebstein Anomaly
© 2025 All rights reserved
NRCME DOT Questions and Answers
CAD
Ans: At least annual examination, and be on board with cardiology,
tolerate and comply with meds. No need to disqualify right away.
Acceptable Echo -
LVEF >/= 40%
Pulmonary artery pressure <50% systemic systolic BP.
Acceptable exercise tolerance -
Achieve >6 mets through Bruce stage 2 or equivalent (medium work up
to 50 lb carrying)
Attain HR of >/=85% predicted maximum unless on beta blockers
Rise in systolic BP >/= 20 mm/hg without angina.
No ST segment depression
Post MI
Ans: drivers must wait 2 months minimum. 1 year maximum.
Must be asymptomatic.
Tolerate meds
Acceptable ETT after the MI, and biennial after that
LVEF >/=40 (REQUIRES ECHO)
Needs cardiology clearance
Angina -
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, 2 | Page
Ans: Needs 3 month wait after angina.
Maximum of 1 year certification
Biennial ETT (Q2Y)
Cardiology clearance
Clearly delineate cardiac cause vs other cause. If this is transient and
noncardiac, treat the patient as if they do not have a condition. Not all
chest pain is cardiac angina.
CABG -
Ans: Sternum must be completely healed after this.
Minimum 3 month return
Maximum 1 year certification.
Annual ETT
Cardiology clearance.
PCI -
Ans: 1 week waiting time.
Maximum of 1 year clearance.
Cardiology clearance.
Biennial ETT
Pacemakers
Ans: Minimum 1 month wait if sinus node dysfunction / AV block
Minimum 3 month wait if hypersensitive carotid sinus with syncope
Maximum cert of 1 year
Needs routine pacemaker checks. Patient needs documentation.
SVT
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, 3 | Page
Ans: Minimum 1 month wait on anticoagulation and asymptomatic
1 month wait post isthmus ablation and diagnosis is atrial flutter
1 month wait if asymptomatic if AV reentrant tachycardia, WPW, atrial
tachycardia, junctional tachycardia
Maximum certification of 1 year.
Cardiology clearance + Annual cardiology visit.
Ventricular arrhythmias
Ans: Minimum 1 month wait if coronary heart disease, RV outflow V-
tach, Idiopathic LV V-tach
Maximum 1 year cert.
Cannot be sustained, nonsustained requires LVEF >/=40%
CANNOT CERTIFY hypertrophic cardiomyopathy, Long QT, Brugada
Heart Failure
Ans: Use NYHA classes (Only certify class 1)
Maximum 1 year certification.
Syncope
Ans: Requires a 3 month waiting period.
Maximum cert of 1 year.
Ebstein Anomaly
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