I also had the stress ECG show up a problem that resulted in CASA suspending my Class one medical. The Angiogram that I was recommended to undertake, showed about 70% blockage in the LAD and the cardiologist said the outcome would not be just a heart attack!
A triple bypass followed a few weeks later with 8 days in hospital and 6 weeks of rehab during which the docs would not let me ride my road bike (the exercise bike was OK though) but instead had me build up my walking times.
At the 6 month stage my cardiologist and I had an argument with CASA re the need for a Stress nucleotide scan given that CASA allowed an Echo cardiogram where stents had been used to fix artery blockages.
My Cardiologist did some research into radiation effects from the nucleotide scans and found that a scan was equal to about 230 chest X-Rays. CASA then changed the requirement so that either the Stress nucleotide scan (preferred) or stress echocardiogram were acceptable for Class one renewal assessment where a CABG had been performed.
I successfully completed the stress echocardiogram and was issued with the Class one within a few days. Initially it was restricted to “renew by CASA” and now for the last two years it is only subject to CASA audit and routinely renewed by my DAME as I am now a “Known Quantity” heart wise!
Apart from the “argument” mentioned above, CASA have been very helpful with no delays experienced.
In the end it is just process, so wait out your time, get fit, then follow the requirements as shown in the following extract from the DAME handbook (which does not seem to be available on line at the moment. Your DAME though, should have a copy anyway).
Issue of Aviation Medical Certificate Following Coronary Artery Bypass Graft (CABG).
Class 1, 2 or 3 Medical Certificates
Following the graft, inform CASA Aviation Medicine Section of the diagnosis and advise applicant not to exercise the privileges of his/her licence until cleared to do so by CASA.
This will not be considered until six months after the surgery for Class 1, 2 or 3.
Recertification
Investigations required for recertification are:
�� Routine aviation medical assessment
�� Cardiologist’s assessment
�� Stress nucleotide scan (preferred) or stress echocardiogram
�� Ejection fraction estimation
If all of the above investigations are satisfactory, the subject may be recertificated for 12 months without restriction.
Subsequent Reviews
12-month intervals post coronary artery bypass graft:
�� Routine aviation medical examination
�� Cardiologist’s review every six months
�� Stress ECG yearly.