Return to flying after heart attack?

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I am trying to understand how soon I can safely return to flying after a heart attack. Prior to the event, I was using basicmed, which is no longer valid. I have decided that I'm NOT going to spin the SI roulette wheel, so my flying will be limited to LSA in the future, which is fine for the kind of flying I do, especially if MOSAIC passes next year. As such, I'm only limited by the vague prohibition on flying "while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner." But I want to do the right thing. The cardiologist flatly said, "6 months", but it's clear he knows nothing about flying.

I gather my case was atypical. There was no pain, just extreme dizziness before I passed out and stopped breathing. Wife gave me a few rescue breaths and I regained consciousness after 15-30 seconds. LAD artery was 100% blocked and is now stented. LCx 50%, RCA 60%, nothing done there. Ejection fraction 49%. Now taking Toprol (beta blocker), Crestor (statin), Brilanta (blood thinner), and asprin. A month later, I'm still tired but improving every day. I know I'm not ready to fly yet but I'm hoping I'll feel up to it in a month or to.

I saw a reference somewhere to 3 months for a class III SI, does that sound reasonable? And a stress test, which I'm going to ask for if they don't schedule it anyway. As I said I'm not going to try for a SI but will keep that guidance in mind.
 
my experience was about 18 months for third class SI. No SI gets done in 3 months from what I gathered reading posts here. A simple request for a document, receipt, then processed for review can add three months alone! Don't start it until you are ready for a battle to the death or victory.
 
I think you are right on the money with LSA, and if Mosaic goes thru then , unless you are flying commercially, there is absolutely no reason to waste thousands of dollars on potentially risky SI where a refusal can end up closing the door for good.
 
FatherPilot said:
my experience was about 18 months for third class SI. No SI gets done in 3 months from what I gathered reading posts here. A simple request for a document, receipt, then processed for review can add three months alone! Don't start it until you are ready for a battle to the death or victory.
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As I said, I have no intention of applying for a SI and I wasn't asking how long that takes. My question was about the prudent time to wait before flying a LSA, which does not require a medical of any kind.
 
temporarily grounded said:
As I said, I have no intention of applying for a SI and I wasn't asking how long that takes. My question was about the prudent time to wait before flying a LSA, which does not require a medical of any kind.
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Your cardiologist, who knows your condition better than any of us do, already said 6 months. What answer are you hoping for?
 
Brad Z said:
Your cardiologist, who knows your condition better than any of us do, already said 6 months. What answer are you hoping for?
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In this case "my" cardiologist is a doctor who has seen me just once (the initial post hospital followup at their outpatient location), knows of me only by looking at my chart. didn't listen to much of what I said or answer my questions clearly, and was clearly giving a boilerplate answer based on what he may know of the requirements for airline pilots before rushing off to see the next patient. That is why I'm trying to get a sense of what others have been advised.
 
"Dear Grounded" (most of us are old enough to recognize this format):

You are also grounded by the list of 15 disqualifying medical conditions:

1715173073045.png


The requirments are:
Doc's Admission dictation
Cath report-CAVEAT: There is a structural standard too, "no part of the heart can be behind a 70% or tighter lesion". If you still have any part of the heart behind a 70%: ALL STOP it will be denied (even a small vessel), get that addressed. It's 60% for the Left Main Coronary (59% or less only).
DIscharge summary if any (if you were there > 24 hours there is generally one)

Then (all at >>90 days from the event):
(1) Stress treadmill (and I recommend Stress treadmill Echo) to 9 minutes (if 69 or younger) and at least 90% of your Age related Vmax heart rate. You will need dupl.original tracings - there are at least 35 from the run. They will look at you as if you have three heads when you make this request: Stand your ground. Don't leave the room until you have them. They get overwritten in the Treadmill machine's buffer, quickly. The b/w I.T. dept versions do not image well in FAA's primitive DIWS system (1998). There is a tendancy to neglect the High speed imaging Echo, but 7% of Males have false positive tracings and you only get one Healthcare benefit per year. The high speed echo trumps the EKGs so its' two chances to pass on one test. If your hospital's lab is more comfortable with Stress treadmill nuclear, then so be it. The talent to do the stress echo imaging in the presence of an anterior wall MI and read it correctly is getting rarer and rarer. IN any case get two chances out of one test.
(2) Fasting glucose and lipids
(3) Cardiologist's office visit from after the 90th day. He's got to address your IMPROVED control of your cardiac risk factors or it will not suffice. At your point, a lot of guys control their diet, weight and get that "vegan look" about them.

You should get with an AME who understands jeopardy. Go to a consultant AME (who likely, isn't your AME of record) and prepare and get his opinion before you choose to apply/no apply. But DON'T DO IT THE OTHER WAY AROUND.

By the time the agency gets around to acting on any of this, it'll be 270 days....the backlog is terrible. So I would not worry about the 6 months, you're not flying anyway. GET GOOD ADVICE.

B
 
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Seems like nobody reads what I wrote. I am NOT repeat NOT planning to apply for a medical or special issuance. I don't care what the FAA paperwork requirements are (except maybe as a guide, where reasonable), or what the SI bureaucratic wait time is. What I DO want to do is understand the criteria I (and my doctors) can use to personally evaluate, for light-sport operations not requiring a medical, whether or not I am "unable to operate the aircraft in a safe manner."
 
temporarily grounded said:
Seems like nobody reads what I wrote. I am NOT repeat NOT planning to apply for a medical or special issuance. I don't care what the FAA paperwork requirements are (except maybe as a guide, where reasonable), or what the SI bureaucratic wait time is. What I DO want to do is understand the criteria I (and my doctors) can use to personally evaluate, for light-sport operations not requiring a medical, whether or not I am "unable to operate the aircraft in a safe manner."
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As Brad Z said, you've already got the opinion of your cardiologist, who, regardless of how superficial you believe his opinion to be, has treated you and reviewed your records. No one here can give you a better opinion than that, and you don't really need one. If you nevertheless want a second opinion, you could take your records to a cardiologist who you prefer.
 
As you are well aware, "a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner."

The answer to the question appears to become an opinion as to whether you know or have a reason to know that flying now would not be safe. You stated, "I know I'm not ready to fly yet but I'm hoping I'll feel up to it in a month or to (two)." Does the opinion of this cardiologist matter? I think it does. As @Lindberg noted you could always go to a cardiologist of your choice and get a second opinion. Perhaps in a month you will feel up to flying and a cardiologist recommended by your family doctor will agree.

Hope it works out for you soon. Take care of you ...
 
Did you drive a car to the cardiologist? Did he say whether you could drive or not? Just asking. :stirpot:

My plan is the same as yours. Fly basic med until I can't. Then fly LSA until I can't or possibly shouldn't any more. Mosaic will make the LSA part more comfortable.

Also want to say I am glad it wasn't even more serious and I hope you have many more years of flying!
 
Above all your health comes first,find a cardiologist that has some experience dealing with pilots and get that person’s recommendations.
 
If no FAA medical necessary:

Are you concerned that flying too soon will be detrimental to healing or trigger an event? Otherwise, what is the difference between 5 months vs 7 months?

If you have good decision making to continue aviation, then fly when you feel good enough, whether that’s tomorrow or in 2 years or whatever.

Maybe think about not flying with a passenger unless they can deal safely with an in-flight pilot incapacitation, whether by skill or technology.
 
Bbchien’s 270 days from heart attack to SI in hand was pretty accurate in the event I am aware of.
Pilot was still in the hospital consulting with Dr bbchien who recommended can’t do anything for 90 days. After 90 days get together with a local AME he recommended and gather all the required documentation. Took about 60 days to get the tests and paperwork completed and sent to the FAA. Then about 120 days till the SI certificate showed up.

Brian
CFIIG/ASEL
 
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