Cardiac history is one of the most protocol-driven areas of FAA medical certification. The key is matching your specific condition to the right FAA pathway — and building a complete, organized record.
Informational Use Only. The information on this page reflects our understanding of current FAA medical certification requirements and is provided for general educational purposes only. FAA policies, the AME Guide, and special issuance protocols are updated frequently and without notice. The FAA AME Guide and FAA Civil Aerospace Medical Institute (CAMI) are the authoritative sources in all cases. Nothing on this page constitutes legal or medical advice. Always verify current requirements directly with your Aviation Medical Examiner and the official FAA AME Guide at faa.gov/ame_guide before making any certification decisions.
The FAA's Core Concern: Sudden Incapacitation
For every cardiac condition, the FAA's underlying question is: what is the risk of sudden incapacitation in flight? The entire documentation and testing framework is built around answering that question with objective evidence.
Cardiac conditions span a wide range of complexity. Identifying the right category helps you understand what the FAA requires.
Hypertension managed with medications
Coronary artery disease, stent, angioplasty, or bypass surgery (CABG)
Arrhythmia (AFib, SVT, VT), ablation, pacemaker, or ICD
Valve disease, valve surgery, or valve repair
Heart failure, reduced ejection fraction, or cardiomyopathy
CAD/CHD (including stents, angioplasty, MI, and bypass surgery) is one of the most common cardiac conditions seen in the pilot population. The FAA has formal protocols covering different certification classes.
The most rigorous evaluation pathway. Requires complete catheterization data, protocol-specific stress testing, and cardiology documentation. The AME must DEFER for the initial FAA authorization.
Full documentation package still required, but the pathway can be less intensive in some cases. The AME must DEFER for initial FAA authorization after a CAD event.
AASI means AME Assisted Special Issuance and applies to all medical classes for CHD. Initial authorization requires DEFER. Routine renewals do not require repeat stress testing when every current recertification-summary criterion is met and there are no interval changes or other concerns; follow the FAA authorization.
Across all cardiac conditions, these are the factors that drive the FAA's risk assessment and documentation requirements.
Chest pain, syncope or pre-syncope, dyspnea on exertion, palpitations, or exercise limitations. Current symptom status informs the urgency and type of evaluation.
Initial CHD review requires protocol-specific testing and DEFER for FAA authorization. Routine CHD AASI renewals do not require repeat stress tests when every current recertification-summary criterion is met and there are no interval changes or concerns. Follow any testing specifically required by the FAA.
For stents: the number, location, vessel treated, and whether it was a STEMI or NSTEMI. For surgery: operative and discharge records. For devices: device specifications and the underlying indication.
Blood pressure, cholesterol/lipid profile, diabetes management, smoking history, and BMI. These are part of a comprehensive risk picture.
Some cardiac medications have side effect profiles that matter for aviation — fatigue, dizziness, or effects on cognitive alertness. The FAA reviews the regimen holistically.
Evidence of regular cardiology follow-up demonstrates active management. The FAA views gaps in care unfavorably when reviewing a cardiac history.
Missing catheterization or procedure reports — these are distinct from the discharge summary
Submitting patient portal after-visit summaries instead of formal clinical reports
Wrong stress test type ordered — FAA protocols are specific about the modality required
Stress test performed outside the FAA's timing window relative to the event
No current cardiology note — FAA wants to see active, recent follow-up
Gaps in follow-up care that leave the FAA with no evidence of ongoing monitoring
What sets our practice apart for cardiac certification cases.
HIMS Senior AME
FAA-designated HIMS Senior AME experienced with the full spectrum of cardiac protocols — from hypertension CACI to post-MI special issuance.
Pilot, Not Just a Physician
Active corporate jet pilot (ATP, CFI, CFII, MEI) — understands the physiological demands of aviation and what cardiac fitness means in practice.
Direct Physician Access
You work directly with the doctor. No case managers, no handoffs — one point of contact from consultation through certification.
Remote Consultations
Consultations available remotely to review your cardiac history and documentation before you commit resources to testing.
Modern Patient Portal
A digital patient portal for HIMS phase tracking, document management, and progress visibility.
Two Arizona Locations
Flagstaff and Lake Havasu City offices — serving pilots across the Southwest and beyond.