Download dot medical guidelines cardiovascular disease

DOT MEDICAL GUIDELINES
CARDIOVASCULAR DISEASE
Thank you for choosing us as the providers for your DOT examination for medical clearance.
Here are some guidelines to help ensure a smooth DOT certification or recertification process.
All documentation required below must be presented during the time of the examination.
Failure to do so may result in delaying your certification or disqualification. Please note
that the following are recommendations. Determination of initial certification or length of recertification is at the medial provider’s discretion at the time of evaluation.
CARDIOVASCULAR DISEASE
Acute Myocardial Infarction (Heart Attack)
When a driver has a heart attack, they should immediately be placed on temporary suspension
from DOT certification for two months. To regain certification, the driver must obtain a note of
medical clearance from the cardiologist. Please bring the following additional information for
certification to your examination:
•
The results of your most recent heart stress test performed at your cardiologist’s office.
Stress testing must be done at least every two years in drivers with a history of a heart
attack. Recertification is limited to one year in drivers with a history of a heart attack.
Percutaneous Coronary Intervention (PCI)
Driver who have PCI procedures such as cardiac stents or angioplasty may return to
commercial driving one week after their procedure but only with the approval of the cardiologist.
Re-certification covers a period of three to six months only. A heart stress test is required within
4-6 weeks post PCI procedures before certification can be extended to a full year.
Recertification is limited to one year and a heart stress test should be done at least every two
years after.
Coronary Artery Bypass Surgery (CABG)
A waiting period of three months is recommended prior to returning to commercial driving after a
CABG to allow sufficient time for wound healing. Driver with a history of CABG requires yearly
cardiac stress testing after 5 years. A note of medical clearance by the cardiologist is required
for certification to return to work. Recertification is limited to every year.
DOT MEDICAL GUIDELINES
CARDIOVASCULAR DISEASE
Dear Physician/Cardiologist,
Your patient is currently seeking recertification for his/her DOT medical clearance. A note of
medical clearance is needed to ascertain if the patient’s condition is fit to safely drive a
commercial vehicle. Please provide a note of clearance based on the following Federal Motor
Carrier Safety Administration guidelines for testing and follow up.
Myocardial Infarction
•
A driver may be considered for recertification 2 months post-MI.
•
Documentation of an echocardiogram with a LVEF of ≥ 40.
•
Documentation of a cardiac stress test 4-6 weeks post MI completing stage 2 of the Bruce
protocol. Cardiac stress testing should continue every two years or more frequently if
clinically indicated.
•
Tolerance to anti-angina or antihypertensive meds.
Percutaneous Coronary Interventions
•
A driver may be considered for recertification one week after the procedure if not in the
setting of unstable angina or post MI.
•
There should be no complication at the vascular access site.
•
Please note tolerance to the medications.
•
No ischemic changes on the EKG.
•
A stress test should be done 3-6 months post PCI then every two years for recertification.
CABG
•
A driver may be considered for recertification 3 months after the procedure to allow for
sternal wound healing.
•
Documentation of an echocardiogram with an LVEF of ≥ 40.
•
Tolerance to all cardiovascular medications with no orthostatic symptoms.
•
It is recommended that drivers with a history of CABG have an ETT annually starting 5 years
post procedure.