Cardiology Pt. 2

Question 1

Congenital Heart Disease Certification Period

Answer 1

1 year

Question 2

Congenital Heart Disease Cert Requirements

Answer 2

1. Asymptomatic
2. Mild tricuspid anomaly
3. Mild cardiac enlargement
4. Mild RV dysfunction

Question 3

Congenital Heart Disease DQ

Answer 3

1. Symptomatic
2. More than mild anomaly
3. Intracardiac Lesion (ASD)
4. Shunt
5. Symptomatic arrhythmia
6. Accessory conduction pathway

*may certify after surgical intervention

Question 4

Heart Transplant Waiting & Certification Period

Answer 4

Waiting: 1 year

Max Cert: 6 months

Question 5

Heart Transplant Cert Requirements

Answer 5

1. Asymptomatic
2. Tolerates Meds
3. Cleared
4. No signs of transplant rejection
5. Re-evaluate q 6 months

Question 6

Cardiomyopathy

Answer 6

DISQUALIFY if:
1. Hypertrophic cardiomyopathy
2. Restrictive cardiomyopathy

Question 7

AAA Waiting & Certification Period

Answer 7

Waiting: 3 months post-surgical repair

Max Cert: 1 year

*should undergo annual US to monitor size

Question 8

AAA Certification Requirements

Answer 8

1. Asymptomatic
2. < 4cm
3. > 4cm but < 5cm with clearance

Question 9

AAA DQ

Answer 9

1. Symptomatic regardless of size
2. Recommendation for surgical repair by specialist
3. > 4cm but < 5cm but without clearance
4. > 5cm
5. Increase of size > 0.5cm in 6 months

Question 10

Thoracic Aneurysm Waiting & Certification Period

Answer 10

Waiting: 3 months post-surgical repair

Max Cert: 1 year

Question 11

Thoracic Aneurysm Cert Requirements

Answer 11

1. < 5cm
2. Asymptomatic
3. Clearance

Question 12

Acute DVT Certification Period

Answer 12

1 year

Question 13

Chronic Thrombotic Venous Certification Period & Requirements

Answer 13

Max Cert: 2 years

Certify if Asymptomatic

Question 14

Intermittent Claudication Waiting & Certification Period

Answer 14

Waiting: 3 months post-surgical repair

Max Cert: 1 year

Question 15

Intermittent Claudication Certification Requirements and DQ

Answer 15

1. Sx improved after surgery

DQ if driver continues to have pain at rest

Question 16

Superficial Phlebitis
Certification Period

Answer 16

Max Cert: 2 years

Self limited

Rule out DVT

Question 17

Varicose Veins

Answer 17

Varicose veins alone do not disqualify a driver

Question 18

PE Waiting & Certification Period

Answer 18

Waiting: 3 months w/o additional PE

Max Cert: 1 year

Question 19

PE Cert Requirements and DQ

Answer 19

1. Appropriate long-term treatment

DQ if driver is symptomatic

Question 20

AR Waiting & Certification Period

Answer 20

Waiting: 3 months if surgical repair

Max Cert:
- 6 months if not repaired
- 1 year if repaired

Question 21

AR Certification Requirements

Answer 21

1. Asymptomatic
2. Normal LV function
3. +/- LV dilation but:
   - LV EDV < 60mm
   - LV ESV < 50mm

Question 22

AR DQ

Answer 22

1. Symptomatic
2. LVED < 40%
3. Greater than mild LV dilation
   - LV EDV > 70mm
   - LV ESV > 55mm

Question 23

AS Waiting & Certification Period

Answer 23

Waiting: 3 months post-surgical repair

Max Cert: 1 year

Question 24

AS Certification Requirements

Answer 24

1. Mild stenosis that is asymptomatic
2. Moderate stenosis that is asymptomatic
3. Severe stenosis that has been repaired

Question 25

AS DQ

Answer 25

Moderate stenosis with 1 or more of the following: 1. Angina 2. CHF 3. AFib 4. LVEF < 40% 5. Thromboembolism *DQ if driver has severe stenosis regardless of symptoms of LV function

Question 26

Aortic Valve Repair - Waiting - Certification Period - DQ

Answer 26

Waiting: 3 months post-repair Max Cert: 1 year DQ: Thromboembolic events after repair

Question 27

MR Waiting & Certification Period

Answer 27

Waiting: 3 months Max Cert: 1 year

Question 28

MR Certification Requirements

Answer 28

Mild/Moderate 1. Asymptomatic 2. Normal LV size/function 3. Normal pulmonary a. pressure Severe 1. Asymptomatic Surgical Repair 1. Asymptomatic 2. Clearance

Question 29

MR DQ

Answer 29

1. Symptomatic 2. < 6 METs on ETT 3. Ruptured chordae or flail leaflet 4. AFib 5. LVEF < 40% 6. Thromboembolism 7. Pulmonary HTN

Question 30

MS Waiting & Certification Period

Answer 30

Waiting: - 4 weeks if balloon valvotomy - 3 months if surgical Max Cert: 1 year

Question 31

Untreated MS Certification Requirements

Answer 31

Mild 1. Asymptomatic Moderate 1 Asymptomatic Severe 1. Asymptomatic with clearance

Question 32

Untreated MS DQ

Answer 32

1. Symptomatic 2. Recommendation for surgical repair

Question 33

Treated MS Certification Requirements

Answer 33

1. Asymptomatic 2. Clearance 3. No thromboembolic events 4. No pulmonary HTN

Question 34

Treated MS DQ

Answer 34

1. Thromboembolic events 2. Pulmonary HTN

Question 35

MVP Certification Period

Answer 35

1 year

Question 36

MVP DQ

Answer 36

1. Symptomatic or decreased tolerance 2. Ruptured chordae or flail leaflet 3. Systemic emboli 4. AFib 5. Syncope 6. Tach 7. LVEF < 40%

Question 37

Prosthetic Valves Waiting & Certification Period

Answer 37

Waiting: 3 months post replacement Max Cert: 1 year

Question 38

Prosthetic Valves Certification Requirements

Answer 38

1. Asymptomatic 2. Clearance

Question 39

Prosthetic Valves DQ

Answer 39

1. Symptomatic 2. LVEF < 40% 3. Thromboembolic events 4. AFib 5. Pulmonary HTN 6. INR not therapeutic

Question 40

PS Waiting & Certification Period

Answer 40

Waiting: - 4 weeks if balloon valvotomy - 3 months if surgical Max Cert: 1 year

Question 41

PS Certification Requirements

Answer 41

1. Asymptomatic w/ mild or moderate stenosis 2. Corrected with clearance

Question 42

PS DQ

Answer 42

1. Symptomatic 2. Pulmonary Valve > 50 3. RV pressure > 50% systemic 4. RV Hypertrophy 5. RV Dysfunction 6. Moderate PR 7. Pulmonary artery diameter > 5cm

Question 43

Anticoagulant Therapy Certification Period and Requirements

Answer 43

Max Cert: 1 year 1. Stabilized on medication for at least 1 month 2. Copy of INR results to visit 3. Monthly INR monitoring 4. INR is therapeutic (2-3)