General:

You must provide your medical examiner with the following information:

•    Date of onset valvular disease.

•    Name and location of treating health care professional.

•    What interventions have been done.

•    Medications you are taking.

•    Treatment plan.

•    Side effects of medication. 

•    Report: Any history of chest pain, shortness of breath, shortness of breath while sleeping, swelling of ankles, dizziness or fatigue.

Mild-systolic Grade 2 or less with no signs or symptoms do not require workup.  Venous hum does not require work up.

Specific  conditions:

Aortic regurgitation:

w  Certify if:  Mild or moderate with normal LV function, no LV dilatation and asymptomatic.

w  Certification period:  One year

w  Monitoring:  Echocardiogram every 2-3 years

w  Severe AR:   Refer to CV tables or FMCSA handbook

Aortic Stenosis:

w  Certify if:  Mild or moderate (greater than 1 cm² AVA) if asymptomatic

w  Certification period:  One year

w  Monitoring: Echocardiogram every 5 years for mild, every 1-2 for moderate

w  Do not certify if:  Angina, heart failure, syncope, atrial fibrillation, EF <50%, thromboembolism

w  Severe AS:  Disqualified

Mitral regurgitation:

w  Certify if:  Asymptomatic

w  Certification period:  One year

w  Monitoring: mild:  None, moderate: annual echocardiogram, severe: echo every 6-12 months

w  Do not certify if:  Symptomatic, can not achieve >6 METS on TMET, atrial fibrillation, LV dysfunction, thromboembolism, ruptured chordae, flail leaflet, Pulmonary hypertension

Mitral stenosis:

w  Certify if:  Mild or moderate AND asymptomatic

w  Certification:  Annual

w  Monitoring:  if mild, then none; if moderate, then annual echocardiogram

w  Severe:  Disqualify

Following surgical repair of any valve disease:  Three (3) month wait needed and cardiology clearance.

In all cases, examiner shall refer to the most current version of the Cardiovascular Tables and/or the FMCSA Medical Examiner’s Handbook for any uncertain or complicated cases for further guidance.  Opinions shall be sought from the treating cardiologist(s) and/or CV surgeons as necessary before clearing a driver.