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.

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

Thanks for posting that info RG

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 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 for either cardiovascular disease:

https://www.faa.gov/about/office_org...ardiovascular/


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

https://www.faa.gov/about/office_org...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.

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.