Chance of getting 3rd class medical with tachycardia?

A

AmeliaGrace

Guest
I'm looking into starting flying lessons soon, and wondering if I'll be able to get a 3rd class medical certificate or if I should just give up before I waste my time.

I have what's called inappropriate sinus tachycardia, meaning my heart rhythm is normal, but the rate is too fast. I've had countless cardiac tests to try and find an underlying cause, but there is none. I am currently taking nadolol and ivabradine to keep my heart rate normal. As long as I take those daily, everything is good.

Do I have any chance of passing the medical exam?
 
A big question is going to be whether you have had issue like passing out with this. Docs will answer about the meds, whether you can get a medical and what you need to do.
 
What is your ultimate goal? If you just want to "tool around" for fun, you could become a sport pilot, and fly light sport aircraft, with only a valid driver's license for medical cert.
Otherwise, follow the advice given by the two brilliant AMEs that frequent this forum.
 
Thanks for the replies. I've never passed out due to this issue. I've had ECGs, an echo, and holter test, all normal except for heart rate. I'm not encouraged by what I've read though.
 
Kenny Phillips said:
What is your ultimate goal? If you just want to "tool around" for fun, you could become a sport pilot, and fly light sport aircraft, with only a valid driver's license for medical cert.
Otherwise, follow the advice given by the two brilliant AMEs that frequent this forum.
Click to expand...
I just want to fly. I would love to make a career out of it (not as an airline pilot, but perhaps as an instructor or charter pilot), but I'd be willing to settle for sport if it means I get to fly.
 
Supraventricular tachycardia requiring medication is a special issuance and is:
Stress treadmill
Echo
Holter
Cardiologist’s history and exam.....

and requires Annualy, a visit to the cardiologist with a 24 hour holter recording.....and is not hart to get. ?thence to a Basic Med?
 
Last edited:
bbchien said:
Supraventricular tachycardia requiring medication is a special issuance and is:
Stress treadmill
Echo
Holter
Cardiologist’s history and exam.....

and requires Annualy, a visit to the cardiologist with a 24 hour holter recording.....
Click to expand...
Thanks for the reply. If I go through all that (again) is there any chance it will be approved, or should I not bother? And should I get this all done before I see an AME at all?
 
Not hard to get the approval, but if you value Light Sport, don’t go for a flight physical until you have all of the above and you know it’s certifiable.....you don’t want to apply, get the demand letter, scramble and then discover an issue—> denial and loss of light sport privileges as well.....
 
bbchien said:
Not hard to get the approval, but if you value Light Sport, don’t go for a flight physical until you have all of the above and you know it’s certifiable.....you don’t want to apply, get the demand letter, scramble and then discover an issue—> denial and loss of light sport privileges as well.....
Click to expand...
Good to know there's a chance at least! I will make sure I have all that from my cardiologist before I go for the physical. Thank you.
 
Dr. Chien doesn't "hold out" here for business, but it would be well worth the effort to reach out to him privately if you're anywhere near Illinois, or another proactive senior AME, and consider hiring one of them to oversee your submission. If you post where you're located, someone here could likely recommend an AME. While any AME should theoretically be able to handle this, you don't want to inadvertently choose one who isn't familiar with special issuances or wants to just defer everything, as that could result in lengthy delays or even denial if the correct information isn't submitted in a manner acceptable to the FAA.

The last thing you want to do is just walk into some random AME's office without knowing for certain your application is certifiable. Dr. Chien and others of his caliber won't submit unless and until they're SURE you can receive a medical certificate. In addition, the FAA has certain requirements for the documentation, of which a general cardiologist wouldn't be aware.

And to expand on Dr. Chien's comment about Basic Med, if you just want to fly for fun or be a flight instructor, you can do that with Basic Med. You only have to obtain a third class medical certificate and special issuance one time, thereafter it's up to you and your PCP. However, if you want to fly for hire -- you mentioned charter pilot -- you'd of course need to maintain at least a second class medical, which would require the annual cardiologist visit and 24 hour Holter monitor.
 
BrianR said:
Dr. Chien doesn't "hold out" here for business, but it would be well worth the effort to reach out to him privately if you're anywhere near Illinois, or another proactive senior AME, and consider hiring one of them to oversee your submission. If you post where you're located, someone here could likely recommend an AME. While any AME should theoretically be able to handle this, you don't want to inadvertently choose one who isn't familiar with special issuances or wants to just defer everything, as that could result in lengthy delays or even denial if the correct information isn't submitted in a manner acceptable to the FAA.

The last thing you want to do is just walk into some random AME's office without knowing for certain your application is certifiable. Dr. Chien and others of his caliber won't submit unless and until they're SURE you can receive a medical certificate. In addition, the FAA has certain requirements for the documentation, of which a general cardiologist wouldn't be aware.

And to expand on Dr. Chien's comment about Basic Med, if you just want to fly for fun or be a flight instructor, you can do that with Basic Med. You only have to obtain a third class medical certificate and special issuance one time, thereafter it's up to you and your PCP. However, if you want to fly for hire -- you mentioned charter pilot -- you'd of course need to maintain at least a second class medical, which would require the annual cardiologist visit and 24 hour Holter monitor.
Click to expand...
That would be great if someone could recommend an AME. I'm in the metro Atlanta area. Thank you so much for all the advice.
 
AmeliaGrace said:
That would be great if someone could recommend an AME. I'm in the metro Atlanta area. Thank you so much for all the advice.
Click to expand...

I'm an hour north of ATL and I still used Dr Bruce for my SIs as I wanted to win. Worth the effort, just saying.
 
Bill said:
I'm an hour north of ATL and I still used Dr Bruce for my SIs as I wanted to win. Worth the effort, just saying.
Click to expand...
He is in IL right? I feel like this is just going to get too expensive before I even get started, unfortunately. It breaks my heart, but I might have to give up on it.
 
AmeliaGrace said:
He is in IL right? I feel like this is just going to get too expensive before I even get started, unfortunately. It breaks my heart, but I might have to give up on it.
Click to expand...

Contact Bruce and see where it goes. His fees in my opinion are very reasonable, and a car trip just one time to Clow International is not a big deal. The biggie is the cost of the tests depending on your insurance coverage.
 
Bill said:
Contact Bruce and see where it goes. His fees in my opinion are very reasonable, and a car trip just one time to Clow International is not a big deal. The biggie is the cost of the tests depending on your insurance coverage.
Click to expand...
I have good insurance, but I wasn't sure if they would consider testing for this reason to be medically necessary.
 
AmeliaGrace said:
I have good insurance, but I wasn't sure if they would consider testing for this reason to be medically necessary.
Click to expand...

For my SI the FAA requested a similar set of tests. When I consulted with my cardiologist about these tests and purpose, his reply was they are all tests any Dr would use to over time to assess the stability of my condition, and the insurance company will have no qualms with him ordering the tests. He was correct, and I still have one or more of these tests yearly as part of my ongoing care.

Investigate, determine the requirements, talk with your cardiologist, and then decide if you want to move forward.
 
AmeliaGrace said:
He is in IL right? I feel like this is just going to get too expensive before I even get started, unfortunately. It breaks my heart, but I might have to give up on it.
Click to expand...
I would not think you'd have trouble finding an experienced and qualified AME near Atlanta. You can search here: https://designee.faa.gov/#/designeeLocator

If you limit the search to First Class, it will give you senior AMEs. They'll likely have experience with helping pilots keep their jobs. Maybe ask local pilots who they recommend for "hard cases." And then call a few of them to schedule a "consultation." Any AME who is not willing to schedule a consultation is not the right one for you. After the consultation, if you and the AME are not VERY confident you will get a medical, go the sport pilot route.
 
Lindberg said:
I would not think you'd have trouble finding an experienced and qualified AME near Atlanta. You can search here: https://designee.faa.gov/#/designeeLocator

If you limit the search to First Class, it will give you senior AMEs. They'll likely have experience with helping pilots keep their jobs. Maybe ask local pilots who they recommend for "hard cases." And then call a few of them to schedule a "consultation." Any AME who is not willing to schedule a consultation is not the right one for you. After the consultation, if you and the AME are not VERY confident you will get a medical, go the sport pilot route.
Click to expand...
Thank you, I will look into that as well. I have a discovery flight scheduled tomorrow morning, so maybe one of the instructors will know of someone in the area. I have a feeling that once I get in the air, I'll have the motivation I need to fight hard.

Edit: I always forget my uncle works for the FAA at ATL. Maybe he knows of a good AME.
 
I live in the Atlanta area, but I have been going to Dr. Chien for the last five years. My paycheck requires that I have a 1st class medical and I haven’t lost a single day in those five years, so a day trip on Southwest is worth the cost to me.

If I were to switch to someone local, it would be Dr.Thomas Faulkner. He is located near ATL.
 
Dave Theisen said:
I live in the Atlanta area, but I have been going to Dr. Chien for the last five years. My paycheck requires that I have a 1st class medical and I haven’t lost a single day in those five years, so a day trip on Southwest is worth the cost to me.

If I were to switch to someone local, it would be Dr.Thomas Faulkner. He is located near ATL.
Click to expand...
I can probably work it out to see Dr. Chien if that's the best option. It seems like everyone here recommends him. I'm just worried I'll go through all that and still get denied.

How far is his office from ORD? I have family up there I could probably stay with for a night.

Edit: I just sent Dr. Chien an email. Fingers crossed that he is able (and willing) to help me.
 
Last edited:
AmeliaGrace said:
I can probably work it out to see Dr. Chien if that's the best option. It seems like everyone here recommends him. I'm just worried I'll go through all that and still get denied.

How far is his office from ORD? I have family up there I could probably stay with for a night.
Click to expand...

Just to drive the point home once again. Dr Chien gave you the path here, you need to get all those tests done and confirm you will get issued before you fill out the medical form on line. The letter from the cardiologist is important as is the interpretation of your tests by a knowledgeable AME before you fill out that form and "go live". ( "Go live" is where you give the code you get when you fill out the med form online, when you give it to the AME, he enters it into his system and it is officially registered at the FAA, your examination has begun and can't be undone.) A good AME will know when you have a good cardiologist letter, it may take a few attempts to get it written properly.

So the concept is that you get a determination as to whether you will be denied or not BEFORE you go for the official exam. If it doesn't look like you will pass the exam, then don't do it, which will preserve your ability to fly under the sport license if you qualify to those standards.

Dr Chien will (or has in the past) consult over the phone and via mail to review your case. His fee is very reasonable for this, it is something you might want to consider before you travel. I don't think he will be offended or really care if you consult with him then find a local AME, who is known for working with more difficult cases, and having the local guy do the exam. If the case looks like it will be definitely approved, then you could go this route. But if it is a more difficult case then travel may be the best option. Just be up front with as to your intentions and make sure you get Dr Chien all the info first time around. Things like a drunk/drug driving arrest, some type of mental issue like meds for anxiety, mental illness, ADHD will be issue also, so fess up if there are other issues.

The key is to have this all figured out, before you go live with the FAA exam. I hope this works out for you.
 
Yes, I understand that I need to get this taken care of before the exam. I just sent Dr. Chien an email. Thanks for your help.
 
BTW, don't discount the Sport Pilot option. Light Sport Aircraft are capable planes and you and one passenger would be able to fly anywhere in the US and the Bahamas during the daytime under visual flight rules. Plus, if you want to instruct, you can become a Sport Pilot instructor as well.

I flew as a Sport Pilot for a while before deciding to go for my 3rd class. I used Dr. Bruce for my SI and it was worth the one day up-&-back flight from Orlando.

Be advised - flying ain't cheap, and your medical will be just a fraction of the overall cost. Dr. Bruce's fees are insignificant in the big picture and frankly, he'd likely make more money with a "tips" jar on his desk than what he gets by charging. He's worth every penny.
 
Dr. Chien will look over your paperwork test and such and if you won't pass he will let you know ahead of time. I used him when I got back into flying and it was great. I flew to Peoria to get the medical exam. It was not expensive and I got to have lunch with Dr. Chien.

Once you get the class three then you can go basic med and not worry about the medical hoops as much.
 
The cost of an airline ticket to ord from Atlanta is small compared to the $15000 or so for lessons.
 
bbchien said:
Supraventricular tachycardia requiring medication is a special issuance and is:
Stress treadmill
Echo
Holter
Cardiologist’s history and exam.....

and requires Annualy, a visit to the cardiologist with a 24 hour holter recording.....and is not hart to get. ?thence to a Basic Med?
Click to expand...

Dr Bruce, do you have a moment to expand on the SVT portion of your prior response? You said that SVT requiring medication is a special issuance. If one gets a successful ablation to stop the SVT altogether and drops meds, is this still a condition that requires special issuance? My SVT has never caused pass outs or anything. It’s been a minor annoyance at most. With meds it’s unnoticed. For that reason I have not done an ablation. But if the ablation would make a better position for issuance it seems like a good idea. Is that the case? Thank you!

@bbchien
 
John Spartan said:
Dr Bruce, do you have a moment to expand on the SVT portion of your prior response? You said that SVT requiring medication is a special issuance. If one gets a successful ablation to stop the SVT altogether and drops meds, is this still a condition that requires special issuance? My SVT has never caused pass outs or anything. It’s been a minor annoyance at most. With meds it’s unnoticed. For that reason I have not done an ablation. But if the ablation would make a better position for issuance it seems like a good idea. Is that the case? Thank you!

@bbchien
Click to expand...
It becomes a condition which is initially a special issuance but then is relaxed.

to the OP: I had forgotten to mention: Check your TSH!!! (This is a thyroid test)
 
bbchien said:
It becomes a condition which is initially a special issuance but then is relaxed.

to the OP: I had forgotten to mention: Check your TSH!!! (This is a thyroid test)
Click to expand...

Thank you Bruce! Is it correct to interpret that as the ablation is a good option then? Or is it just all the same either way for the issuance?
 
Old Thread: Hello . There have been no replies in this thread for 365 days.
Content in this thread may no longer be relevant.
Perhaps it would be better to start a new thread instead.
Back
Top