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View Full Version : Heart Murmur - new development


Unkown Rider
11-27-2017, 09:08 PM
Went to my family Dr. / AME.

Have been out of flying for years and wanted to get back in, so I got a normal average Joe physical before going for the official FAA 1st class.

Dr. noted a heart murmur which was never there before.

I had gone to a Cardiologist a year earlier for mild chest pain, Cardiologist ran nuclear stress tests and echo and sonogram... All clear but Cardiologist made no mention of the heart murmur. A second Dr. also noted the heart murmur.

I've made some big lifestyle changes, no more alcohol, eating clean, cut down on coffee, and doing 3 miles 3 times a week.

So before I go for an FAA physical, I'd like to talk to a Cardiologist who understands the FAA aviation physical. To be clear, I have not ever been grounded and I did not start an FAA physical when my family Dr. / AME noted the new heart murmur, he was performing an annual non aviation physical.

Is AOPA a good source to go to for advice? I believe the technical term is mitral valve prolapse, basically years of hard living has thickened the heart muscle and caused the mitral valve to stick open and click thus allowing blood to back flow causing heart to pump harder to get blood flow to the body.

A Cardiologist recommended L-Carnitine, Co-Q10, Magnesium, D-Ribose, Hylauronic Acid and Omega 3 oil every day and exercise; which has made a world of difference, now I'd like to not fumble this with a self disclosure that causes me to get grounded. I won't lie on a medical exam, but I'd prefer to have a clean bill of health and my AMEs/family Dr's findings an aberration that need never come up if a new AME and a cardiologist clear me. I get there is a right way and a wrong way to answer questions.


Thanks for any advice/experience.


WhisperJet
11-29-2017, 06:33 AM
The FAA is very progressive with regards to heart issues. They are mostly concerned about conditions which can lead to sudden incapacitation.

Also MVP is a very frequently mis-diagnosed condition.

My suggestion would be to talk to AOPA medical, get a full cardio workup, then work with an AME who knows the info you need before hand. Have the package ready to go with everything you need and expect a few weeks for an FAA decision. At worst you will likely operate under special issuance. At best, FAA will clear you unrestricted once they review your paperwork.

In the meantime, be careful with supplements. Magnesium is good, but too much throws out the balance with the other electrolytes which can cause issues.

CaptYoda
12-05-2017, 04:36 PM
https://www.aopa.org/go-fly/medical-resources/health-conditions/heart-and-circulatory-system/mitral-valve-prolapse


Slim11
12-09-2017, 08:59 AM
leftseat.com is another resource you might find useful.

I now fly on a special issuance because of a hypertrophic cardiomyopathy diagnosis. My challenge was proving I was healthy because the condition was misdiagnosed. That process took close to 18 months.

Good luck!

Sqwk7700
12-09-2017, 09:39 AM
Iím not sure where you are located but Dr Raniolo in Phoenix is an AME and cardiologist. He might be a good resource as well, very pilot friendly AME.

FAA Flight Physical | Arizona AME | Special Issuance | FAA Cardiologist | FAA Medical | FAA Medical Exam | FAA Special Issuance | Aerospace Cardiology (http://www.aerospacecardiology.com)

MadmanX2
12-09-2017, 10:14 AM
As a recent recipient of a heart attack, health is more important than flying.

Don't know your age but do not cut back on coffee, instead eliminate all caffeine and sugar. Good on changing diet and getting exercise.

My cardiologist recommended taking Omega-3 fish oil.

As whisperjet suggest, talk to AOPA medical, get a full cardio workup, then work with an AME who knows the info you need before hand. Have the package ready to go with everything you need.

Consult first with your AME and be sure that you will pass the medical before turning anything in to the FAA.

Good luck to you.

Gary1987
02-12-2018, 02:33 PM
Greetings,

I have done the 1st Class physical, the AME cleared me in every category except.. the heart murmur I have. It has never been a problem, i lift weights, bike, and row 4-5 days a week. The FAA wants 2 further tests, from a cardiologist. I am in Hershey,Pa. anyone have any suggestions on what cardiologist to use for these.. being that I am very fit and my AME put notes in my file for how fit I am. I am concerned that a new cardiologist ( mine has retired) wonít be favorable and give me the thumbs up. Also, anyone have any experience in this regard before?

-Gary

PerfInit
02-12-2018, 04:53 PM
Be very careful with supplements. CO-Q10 can cause Insomnia in some peeps and headaches.. Not good!

Otterbox
02-12-2018, 05:25 PM
Greetings,

I have done the 1st Class physical, the AME cleared me in every category except.. the heart murmur I have. It has never been a problem, i lift weights, bike, and row 4-5 days a week. The FAA wants 2 further tests, from a cardiologist. I am in Hershey,Pa. anyone have any suggestions on what cardiologist to use for these.. being that I am very fit and my AME put notes in my file for how fit I am. I am concerned that a new cardiologist ( mine has retired) wonít be favorable and give me the thumbs up. Also, anyone have any experience in this regard before?

-Gary

Your level of fitness activity may be the catalyst for the murmur..

Hershey Penn state should have a decent cardiology department. If not, Georgetown University or John Hopkins should be able to help you out.

rickair7777
02-12-2018, 05:58 PM
In the meantime, be careful with supplements. Magnesium is good, but too much throws out the balance with the other electrolytes which can cause issues.

This. Fish oil / omega 3 can definitely cause heat rhythm issues.

I would seriously drop all the supplements for a while (but talk to your doc first). If you eat right and live healthy, you probably don't need supplements or vitamins.

rickair7777
02-12-2018, 06:04 PM
Your level of fitness activity may be the catalyst for the murmur.

This too. Serious endurance athletes often have a "rough idle" resting heart rate. The military docs would have us do push ups before the EKG to get above idle. I still do that for FAA KEGs. Except last year... sure enough, got some weird results.

Not sure if the OP runs enough for that to be an issue.

RadialGal
02-13-2018, 11:31 AM
I will second what Rickair7777 said.

I am a very tall, very thin, very athletic female aviator. My resting pulse can be as low as 45, my BP as low as 80/40. I initially showed up as a strong indication for Mitral Valve Prolapse on my very first FP.

My first AME who saw this when I was a young pup (22) with a mere 4 hrs under my belt was kind enough to tell me that tall, thin females often show as a false positive for MVP and other Murmurs. Especially when laying down (as my heart was listened to at that time). He suggested I go to a cardiologist and run the full regime; suggested that I probably didn't have MVP, but was instead a rail thin, healthy female. I did, I passed with flying colors, sent the findings along with my initial app for 1st Class, was issued one with no limits or SODA's. I have been able to pass my 1st class for just over the past 2 decades the very same way. OKC seems to remember my past, and keeps issuing me 1st class'. My pulse/BP remain abnormally low but with with zero side effects.......I can still pull 9 G's in my pals Sukhoi-29 with full color and nothing approximating a grey out.

I guess I am saying be careful. See a Cardiologist first if you have been told you have a Murmur. These folks, unlike your average Family Doc or AME know the characteristics of folks with false positives. Tall, thin, athletic males have nearly the same risk of popping positive for a Murmur. I was blessed with dumb luck on my first AME; just trying to pass along the knowledge.

Keep the Oily side down; unless practicing Acro!

RadialGal

TiredSoul
02-13-2018, 01:44 PM
Thanks for posting that info RG

turbinepilot2
08-03-2019, 07:20 AM
Anyone know of a list of cardiologists who offer aviation first class medicals? Getting abnormal ECG flags and I think it's time to bring in a heavyweight.

Excargodog
08-03-2019, 10:48 AM
Anyone know of a list of cardiologists who offer aviation first class medicals? Getting abnormal ECG flags and I think it's time to bring in a heavyweight.

Get a GOOD cardiologist conveniently close to where you live, then get the best treatment possible for whatever he/she finds and get copies for your AME.

This isnít about getting a cardiologist who knows how to work the system, itís about assuring the FAA that you have been optimally treated and reduced to the maximum extent possible the chances of you being suddenly incapacitated.

Their protocols for either cardiovascular disease:

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/cardiovascular/


Or cardiovascular disease resulting in an MI or requiring surgical treatment:

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/dec_cons/disease_prot/coronary/

are actually pretty straightforward. Clearly in the latter cases they really cover their posteriors and it can easily take 6 months, but most people who follow accepted treatment guidelines get approved. So get an evaluation from the best cardiologist in your area and find out what - if anything - is going on.

turbinepilot2
08-03-2019, 11:16 AM
Get a GOOD cardiologist conveniently close to where you live, then get the best treatment possible for whatever he/she finds and get copies for your AME.

This isn’t about getting a cardiologist who knows how to work the system, it’s about assuring the FAA that you have been optimally treated and reduced to the maximum extent possible the chances of you being suddenly incapacitated.

Their protocols...

Yes, good advice. The backstory here is, I got a deferred medical certificate and went for an echocardiogram to resolve it, sent it to the FAA, after a few months they cleared me and issued the darned medical. That was $70,000 in lost wages later. This should never have happened. I am a fit 50 year old able to run miles at a time in summer heat without getting winded, no prior health issues, no family history, nothing. In the FAA aviation medical system you are guilty until proven innocent. That's the way it should be for public good, but the problem is how many GPs really do not have the skill required to evaluate an abnormal ECG trace. Not their fault as ECG traces are both highly complex and inconclusive. But that's what you're up against when you get anything close to an abnormal trace.

I was thinking to avert the whole problem by going to a better AME in the first place. I nearly quit flying because of nothing, as the echocardiogram later pointed out. Not to mention how emotionally traumatic the deferral was.

Thanks.