Read up on these diseases, get treated if needed, and gather all the needed documentation for a Special Issuance before your appointment. Diseases of blood vessels, for the most part, require an FAA decision prior to issuance of a Medical Certification. Renewals can often be done in the AME's office without waiting for AMCD review.
Many types of heart rhythms can be approved, however, some types of heart rhythms are known to risk fainting or incapacitation and these require additional evaluation before approval. AOPA has published a brief article on arrhythmias here. An irregular heart beat requiring treatment with a pacemaker requires a two month recovery period followed by submitting a packet of testing documents. Swapping out a generator implant only requires a 10 day minimum recovery, but lead swaps are still a two month recovery. Followup testing is now extended to a one year interval, battery life permitting ( > 18 months). Automatic Implantable Defibrillators (AICD) are definitely disqualifying, but if the defibrillator function can be shut off by the cardiologist after it is no longer needed, then a Medical is again possible.
Clinically significant coronary heart disease isn't precisely defined in the regulation. The term usually refers to the presence cardiac chest pain (angina), an abnormal treadmill stress test, a change of greater than one millimeter in what cardiologists call the "ST" segment of the electrocardiogram, an abnormal radionuclide myocardial perfusion scan (thallium or sestamibi are commonly used radioisotopes), or an coronary artery X-Ray test (angiogram or Coronary CT) indicating 50% or greater blockage of any coronary artery. With a history of heart abnormalities, the FAA will ask for all the available medical records. Previously, the FAA required a six month recovery period after stents, PTCA or atherectomy, now the minimum recovery period is three months (excluding stents of the Left Main Coronary which is still six months.). After open surgery (coronary bypass grafting or CABG), the recovery time is still six months, but after any type of intervention, the follow up testing now will only need a 3 min exercise stress test, not nuclear scans (except in a few special cases).
After a heart attack (MI), the minimum recovery down time is now also just three months.
You may also be asked to provide a cardiovascular evaluation that includes a current exercise treadmill stress test, routine laboratory blood chemistry report, and a report of a general physical and cardiac examination. If the stress test indicates anything abnormal, more specific test like a myocardial perfusion scan or exercise echocardiogram may be requested. The FAA Protocol is here. If you have had a procedure done, like a CABG or stenting, etc., you will need to provide a copy of the procedure report to send to AMCDAerospace Medical Certification Division of the FAA in Oklahoma City . If you are seeking a First Class Medical or, an Unrestricted Second Class, the FAA requires some additional testing.
The FAA requirements for treadmill stress tests are different from what most clinical cardiologists order. Be aware that the FAA requires an official "Bruce" protocol, prefers that the Airman reaches 100% of predicted maximal heart rate and will not accept tests where the heart rate does not exceed 85%. You must be on the treadmill for at least 9 minutes, and not stop as soon as you get winded.Make sure your cardiologist read this set of guidelines so that you do not waste your time and money on a non-qualifying stress test
Valve replacement (not simple valve repair) surgery, while disqualifying, is subject to Special Issuance by AMCD. The FAA in 2013 decided to begin allowing Special Issuance certification of airmen with two valve replacements whereas, previously, more than a single valve surgery was absolutely disqualifying.
At this time the FAA is again certifying a few pilots after this surgery. Extensive documentation is required, but if you have had a heart transplant, the odds are that your surgeon and cardiologist are getting these tests already.
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