Echo Results

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Anonymous1979

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So I had an echocardiagram and the cardiologist reported that it was mostly normal with an EF of 65% however they did say that my ascending aorta is "mildly" dilated at 3.7 cm and Sinuses of Valsalva is "mildly" dilated at 4.2 cm. I realize that this is something I'll likely have to get a new SI for at some point but how does it work when the numbers are what they are. The cardiologist wants to get a CT and said it's very likely they''ll just want to continue to watch with what they said was serial imaging to monitor it. I've had a nuclear stress test which they said was stable and EKGs have all been normal. So if you have a dilated aorta that doesn't require surgery and they just want to monitor it, how does that all play out for a special issuance.
 
the faa will want to monitor it too ... likely in the for of an SI, as your cardiologist will also be doing.
 
The FAA monitors the aortic root above 4.0 cms. It's a special issuance. You need, a Stress TMT to 90% of (220-YourAge) for peak heart rate and 9 minutes' duration (I hope your nuclear stress met that nas was not a "seated" stress" *(whcih they will accept 3rd class only, if you have an othropedic reason why you cannot run); Current Echo ro CT to get the current dimension (good for 90 days), and the Cardiologist's office visit record.

PS you need the EKG tracings from the stress nuclear......
 
Is the aortic root the Sinuses of Valsalva? Also the nuclear stress test I did was on a treadmill which I did to completion of the test. Would I just send them all of this with a letter saying hey I have a new medical condition and need to request an updated Special Issuance? My current one expires at the end of this month anyway.
 
bbchien said:
The FAA monitors the aortic root above 4.0 cms. It's a special issuance. You need, a Stress TMT to 90% of (220-YourAge) for peak heart rate and 9 minutes' duration (I hope your nuclear stress met that nas was not a "seated" stress" *(whcih they will accept 3rd class only, if you have an othropedic reason why you cannot run); Current Echo ro CT to get the current dimension (good for 90 days), and the Cardiologist's office visit record.

PS you need the EKG tracings from the stress nuclear......
Click to expand...

Going to repost this with what you wrote so I can address it correctly. So I can send them either the echo I just got last week or the CT and can I send them the nuclear stress test from earlier this month along with the EKG tracing from it as well and the notes from the cardiologist? I'm just trying to streamline all this so I'm not going back and forth. And lastly would I just send a letter stating I was diagnosed with a new medical condition and need my current SI updated and just put all the paperwork from the cardiologist with it? On a side note I was able to complete the treadmill portion of the stress test with no problem and the cardiologist said it was stable.
 
If Dr Bruce or Dr Lou can take you on, I would hire one of them to help you navigate the waters.

Signed,
A happy customer!
 
bbchien said:
Stress TMT to 90% of (220-YourAge) for peak heart rate and 9 minutes' duration
Click to expand...
Slight thread drift. I know my peak heart rate pretty well from bike racing. My measured max is about 6bpm slower than the formula of 220-age. If I ever needed to take this test, is being unable to hit the formula max a problem? The measured max is from doing flat out short intervals as well as from couple races. I know I'm incapable of getting it any higher, and I'm in darn good shape for my age. More curiosity than anything else.
 
Hang 4 said:
Slight thread drift. I know my peak heart rate pretty well from bike racing. My measured max is about 6bpm slower than the formula of 220-age. If I ever needed to take this test, is being unable to hit the formula max a problem? The measured max is from doing flat out short intervals as well as from couple races. I know I'm incapable of getting it any higher, and I'm in darn good shape for my age. More curiosity than anything else.
Click to expand...

FAA will have you do the Bruce protocol. It’s on a treadmill and you’ll be wired up. Every minute or two the incline goes up from a 10% grade to 22% and the speed increases up to 6mph or so. I had to go to 10 or 11 minutes before I barely hit the FAA’s magic number. As soon as that happened, I had to hop off, lay down and do the stress echo fairly quickly.

If you have to do the bruce stress test for the FAA, take the extra few minutes and have them do the stress echo in conjunction with it.

https://www.verywellfit.com/the-bruce-treadmill-test-protocol-3120269
 
Hang 4 said:
Slight thread drift. I know my peak heart rate pretty well from bike racing. My measured max is about 6bpm slower than the formula of 220-age. If I ever needed to take this test, is being unable to hit the formula max a problem? The measured max is from doing flat out short intervals as well as from couple races. I know I'm incapable of getting it any higher, and I'm in darn good shape for my age. More curiosity than anything else.
Click to expand...
They ask for 100%, want 90% and the mandatory denial is set at 85%…..
 
Hang 4 said:
Slight thread drift. I know my peak heart rate pretty well from bike racing. My measured max is about 6bpm slower than the formula of 220-age. If I ever needed to take this test, is being unable to hit the formula max a problem? The measured max is from doing flat out short intervals as well as from couple races. I know I'm incapable of getting it any higher, and I'm in darn good shape for my age. More curiosity than anything else.
Click to expand...

Not everyone fits the 220-Age guideline. From bicycling I know I’m capable of about 15bpm above the 220-Age. Some can’t get near it, yet they’re just as fast and just as fit. I take it as a rule of thumb.
 
Bill said:
Not everyone fits the 220-Age guideline. From bicycling I know I’m capable of about 15bpm above the 220-Age. Some can’t get near it, yet they’re just as fast and just as fit. I take it as a rule of thumb.
Click to expand...
Max heart rate is based on your biology, and supposedly it doesn't change much with fitness. I can hit a few points higher than 220-age on a vigorous ride (not VO2 max) and could average 85% of that for a full century.
 
My max has stayed pretty flat at 150 for years. Big gap to the 220-age formula when I was 40, much less of a gap now. Might have been 160 when I was a Cat2 in the 80's and we first started measuring heart rate as part of training.
 
Anonymous1979 said:
So I had an echocardiagram and the cardiologist reported that it was mostly normal with an EF of 65% however they did say that my ascending aorta is "mildly" dilated at 3.7 cm and Sinuses of Valsalva is "mildly" dilated at 4.2 cm. I realize that this is something I'll likely have to get a new SI for at some point but how does it work when the numbers are what they are. The cardiologist wants to get a CT and said it's very likely they''ll just want to continue to watch with what they said was serial imaging to monitor it. I've had a nuclear stress test which they said was stable and EKGs have all been normal. So if you have a dilated aorta that doesn't require surgery and they just want to monitor it, how does that all play out for a special issuance.
Click to expand...

Sounds familiar, might you also have a bicuspid (2 leaflet) aortic valve?

In my case, it grew at an average of .125/year or so. The FAA required a yearly echo until it hit 4.0, yearly echo and ct scan until it hit 5.0. They would not approve above 5.0 and required surgery to repair/replace.
 
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