CFR Part § 67.111 - Pilot Standards: Cardiovascular requirements for 1st class medical certificate

Pilot Medical Standards from CFR Part 67 for Aviation Medical Certification

Mar 2014

Abbreviated Briefing:
  • 1st Class pilots can't have: MI, Angina, Significant CHD, Artificial Heart Valves, Pacemaker or Cardiac Transplant
  • Need ECG at age 35 then annually after 40
  • ECG must be acquired within 60 days of Application


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

Cardiovascular standards for a first-class airman medical certificate are:

  1. No established medical history or clinical diagnosis of any of the following:
    1. Myocardial infarction;
    2. Angina pectoris;
    3. Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;
    4. Cardiac valve replacement;
    5. Permanent cardiac pacemaker implantation; or
    6. Heart replacement;
  2. A person applying for first-class medical certification must demonstrate an absence of myocardial infarction and other clinically significant abnormality on electrocardiographic examination:
    1. At the first application after reaching the 35th birthday; and
    2. On an annual basis after reaching the 40th birthday.
  3. An electrocardiogram will satisfy a requirement of paragraph (b) of this section if it is dated no earlier than 60 days before the date of the application it is to accompany and was performed and transmitted according to acceptable standards and techniques.

This page discussed Pilot Standards: Cardiovascular requirements for 1st class medical certificate

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