Vascular System : What to Expect at the Flight Physical

Item 37: FAA Policies on the Airman Medical Exam

Apr 2014

Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide pages 85-87, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).

I. Code of Federal Regulations

Legal References: 14 CFR 67.113(b)(c), 67.213(b)(c), 67.313(b)(c),

Legal Extract (Applies to All Classes):

  • (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -

    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
  • (c) No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds -
    1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

II. Examination Techniques

  1. Inspection. Observe and report any thoracic deformity (e.g., pectus excavatum), signs of surgery or other trauma, and clues to ventricular hypertrophy. Check the hematopoietic and vascular system by observing for pallor, edema, varicosities, stasis ulcers, venous distention, nail beds for capillary pulsation, and color.
  2. Palpation. Check for thrills and the vascular system for arteriosclerotic changes, shunts or AV anastomoses. The pulses should be examined to determine their character, to note if they are diminished or absent, and to observe for synchronicity.
  3. Percussion. N/A.
  4. Auscultation. Check for bruits and thrills.

III. Aerospace Medical Disposition

The grid below is a table that lists the most common conditions of aeromedical significance, and course of action that should be taken by the examiner as defined by the protocol and disposition in the table. Medical certificates must not be issued to an applicant with medical conditions that require deferral, or for any condition not listed in the table that may result in sudden or subtle incapacitation without consulting the AMCD or the Regional Flight Surgeon. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.


FAA Aerospace Medical Disposition Grid for
Item 37. Vascular System

Vascular Conditions

(Conditions Affecting Your Arteries or Veins)

DISEASE/CONDITION

CLASS

EVALUATION DATA

DISPOSITION

Aneurysm (Abdominal or Thoracic)

All

Submit all available medical documentation

Requires FAA Decision

Aneurysm

(Status Post Repair)

All

Submit all documentation in accordance with CVE Protocol, and include a GXT (Maximal Graded Exercise Stress Test)

Requires FAA Decision

Arteriosclerotic Vascular disease with evidence of circulatory obstruction

All

Submit all documentation in accordance with CVE Protocol, and include a GXT (Maximal Graded Exercise Stress Test), and CAD ultra sound if applicable

Requires FAA Decision

Buerger's Disease

All

Document history and findings

If no impairment and no symptoms in flight - AME Authorized to Issue the Certificate

Otherwise - Requires FAA Decision

Peripheral Edema

All

The underlying medical condition must not be disqualifying

If findings can be explained by normal physiologic response or secondary to medication(s) - AME Authorized to Issue the Certificate

Otherwise -

Requires FAA Decision

Raynaud's Disease

All

Document history and findings

If no impairment - AME Authorized to Issue the Certificate

Otherwise - Requires FAA Decision



Phlebothrombosis or Thrombophlebitis

1st & 2nd

See Thrombophlebitis Protocol

Requires FAA Decision

3rd

Document history and findings

See Thrombophlebitis Protocol

A single episode resolved, not currently treated with anticoagulants, and a negative evaluation - AME Authorized to Issue the Certificate

If history of multiple episodes - Requires FAA Decision



This page discussed the Vascular System portion of the Cardiovascular section of the Fight Physical Examination required of pilots.


Reminder: use FlightPhysical.com to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now