FMCSA DOT LATETS UPDATE GRADED A+

FMCSA DOT LATETS UPDATE GRADED A+ CV disqualifiers ECG- Ischemic changes at rest EF - <40% ETT - unable to pass or complete Angina at rest or change in pattern Symptomatic Poor tolerance of medications CV procedures wait periods Post PCI- Wait period one week, ETT 3-6 months after PCI Post MI- Wait period 2 months, LVEF > 40%, ETT every two years Post CABG - Wait period 3 months, LVEF >40% and after 5 years needs an annual ETT Any cardiac surgery 3 month wait period Cardiomyopathies Hypertrophic or restrictive - NO Idiopathic - Yes if... Asymptomatic, LVEF >40%, no ventricular arrhythmias Asymptomatic, LVEF >50% if ventricular arrhythmias present Annual certification with cardiac evaluation that includes echo and holter. Any cardiovascular disease ANNUAL certification Ventricular Tachycardia Sustained vtach >15 sec EF <40%- do not certify EF >40% and asymptomatic- wait period of one month after successful treatment and cleared by cardiologist Annual certification SVT Prognosis is excellent but may have syncope or symptoms of cerebral hypoperfusion WPW - pre-excitation presents risk for death or syncope if atrial fibrillation develops Wait period of 1 month Annual certification if asymptomatic A Fib Anticoagulated for 1 month Monitored by monthly INR Rate/rhythm control deemed adequate Annual certification Pacemakers Certify annually if... One month after implantation, unless neurogenic or carotid sinus syncope, wait period is 3 months Documented correct function and regular pacemaker checks Underlying disease not disqualifying Defibulators are disqualifying Aortic stensosis Mild - annual cert if asymptomatic, echo every 5 years Moderate - 3 month wait period after surgery, certify annual with echo every 2-3 years Severe - NO unless 3 months post surgery, certify annual Aortic regugitation Mild and moderate disease: Annual certification Echo every 2-3 years Severe aortic regurgitation: (see guideline) Mitral regurgitaiton Mild - certify annual Moderate - certify annual if echo shows normal LV size and function Severe - annual if asymptomatic, echo every 6-12 months. NO if symptomatic Mitral stenosis Mild: MVA >1.6 Moderate: MVA 1.0-1.6, certify annual if asymptomatic