Failed class 1 medical (help)

[mosley]

My son failed his class one medical yesterday, he is devastated, he has been flying since 13 yrs of age and is now 18, passed his PPL and got a JAA and was going on to night rating etc, planning on going to flying school in Spain from next Feb, he is a total wreck as nothing else entered his head other than being a commercial pilot, he has an eptopic heart beat and has to have a 24 halter fitted, if that fails dont know how he will cope.
Is there any other flying he could do with a class 2 medical for a career? would really appreciate any help if there is any, thank you in anticipation.
His medical was taken in Gatwick.

[HEATHROW DIRECTOR]

Just about everyone in the world has the odd ectopic heartbeat. I first noticed mine when I was 16 and they dismissed as "nothing out of the ordinary". I held a Class 1 Medical for nearly 40 years with no problems. Please tell him to stop worrying, because that can make it worse, as can drinking too much coffee.

[millerscourt]

Is the medical failure permanent or temporary? The CAA are usually very helpful by all accounts with medical problems and would I have thought have told him whether there was a way around this or not.

[Robot1]

Many ATCOs / Pilots have the old 'White Coat Syndrome' at the med & have to wear the monitor for 24 hours.... not unusual

[doubleu-anker]

Good advice above. Tell him not to worry, as none of us are perfect. If we were we would all live forever!

Anyone of us can drop dead with a heart attack at anytime, therefore most public transport operations have two pilots.

[Docfly]

You say he has failed his medical, that sounds like nonsense. He is having a 24hr monitor fitted to exclude anything more than just the odd ectopic which would be fine for Class one in the absence of any underlying condition. Stop being a pessimist, it sounds to me like he hasn't failed yet.

[mosley]

He has to wear this alter for 24 hrs and we send the results back, then they tell us if he has passed or not, just anticipating the worst, the other way would be like winning the lottery, thx for replying.

[mosley]

Hi hope you are right, will let you know the results.

[Airclues]

Search for 'ectopic' on PPRuNe. Plenty of information here'

http://www.pprune.org/search.php?searchid=7996266

[AvMed.IN]

Mosley,
Your son is being monitored with the 24 Hr Holter. This is to find out anything sinister, which could render him incapacitated in flight, thus compromising not only his safety but that of his passengers as well.
At this point, please wait to hear what is reported by the Medical Authorities. For all you know, he is absolutely fine, and everything shall turn out just fine :-)

[OldChinaHand]

Mosley, its nothing to worry about at this time, I have done the 24 Hr Halter and the stress ECG to check things out, not a bother, fit as a fiddle. Ectopic beats are usually not an issue. If they are happy with his results, then he will get his Class 1.

[Foniac]

I had one of these... came back as nothing to worry about. I was told a large majority of youngsters have them and its only the a very minute few that its anything to worry about.

I hope it comes back with good results! :)

[homonculus]

This poor chap is 18 not a geriatric like the rest of us. This is a totally different situation from the more common ectopics which may signify pathology in middle age

I agree by far the most likely is that this is utter nonsense - personally I would never arrange a 24 hour tape unless I had examined the patient several times unless there is something else........... In which case it will be normal 24 hour tape, red faces all round and on with the flying

In the VERY unlikely instance that there is something wrong at this age, it really is better to have been detected and although you may not agree a blessing in disguise

[mosley]

Hi thanks to everyone who has took time to comment, I must say I am more confident now, I will let you all know how he gets on, thanks again, what a great bunch of people on here.

[mosley]

Hi I posted recently that my 18yr old son failed his class 1, and quite a few of you guys were kind enough to help, well he had to see a cardiologist who really put him through it, he had a 24 hour halter, Sound, ECG, Stress test on tread mill, (he broke the record on the tread mill ) cardiologist said we will be here all night you can stiop now.

Then he was sent for a MRI scan because the eptopic beats were coming from his right ventrical, results just back, nothing wrong, cardiologist said that he was getting 15% eptopic beats which is a little high and it now goes to another Dr to see what significance this would be.

So after all that we are still waiting, would like youe comments / advice please guys.

[mosley]

My son had all the heart tests because of eptopic beats, he finished off with a MRI scan of the heart because the beats were coming from his right ventrical, he was passed ok, they said he had more eptopic beats than normal 15% can anyone tell me what percentage is the norm? we are waiting for the CAA verdict on weather he gets his class one.

He is only 18 yrs old and super fit, its so frustrating.

[HEATHROW DIRECTOR]

I believe they are "ECTOPIC" beats and they are very common. I've had them for 50 years on and off, but never during an ECG for a medical. I'm sure someone said you're allowed 2 per ECG session.. but I might have that wrong.

I'm sure he'll be OK and don't let him worry because anxiety can cause them..

[Thomas coupling]

mosely:
Even if it comes back suspect, the CAA will bend over backwards to ensure your son gets a fair hearing. They are only the regulators who dispense the rules, nothing else. They see everything in black and white on behalf of the 'system' to ensure it is fair for everyone.
Your job - if it does seem an unfair decision is to go to a reputable consultant cardiologist, preferably an AME to boot (Aviation Medical Examiner) and the best would also be a pilot. They are like hens teeth.
The good news Mosley, is that you probably live inside the catchment area of such a person! Do you live far from The alexander hospital, Machester?
If you do AND your son needs help - PM me. I've been down this very road.
Good luck Mosley jnr!

[hughcant]

As far as I can tell from my tortuous communications with the CAA medical department, it will not issue an unrestricted Class 1 medical certification if the number of ectopic beats exceeds 2% (12 every 10 minutes at a heart rate of 60bpm).

I know this because I have just had an OML slapped on me because the percentage of ectopic beats I am getting is 10% along with couplets and triplets. This is in spite of having had an echo and stress ECG which show no sign of ischemic heart disease. Interestingly, I was allowed to hold an unrestricted Class 1 for over 8 months after discovery of the ectopic beats but now it has been shown I do not have heart disease, I have had a multi-crew OML placed on me:\! Furthermore, the AMEs at CAA admit that there is no evidence of the prognostic significance of extra beats in otherwise normal individuals; so, it appears to me to be an a**e covering exercise!

I will be fighting this decision as I am unable to see the logic being applied,(the CAA hasn't followed the JAA ectopy protocol is dealing with my case!), and I suggest you do the same for your son. You might also want to investigate the possibility of your son going down the multi-crew licence path as it may be that he could still do this with a restriction to his Class 1. Good luck and keep updating the forum as I would be interested to hear the outcome.

[BritishGuy]

I just had a class one medical done today and they say that i have a potential Left Bundle Branch Block. It came up on the ECG and again on the stress test. Funny thing is only 6 months ago I had a foreign medical done and nothing showed. I've got the holter on me and will be getting this sorted (I hope). Only thing is I think they've already decided to slap an OML Multi Crew on me - and I don't want or need it! I already fly and have been for 6 years as a career and I really don't want the restriction. What can I do? They admitted that these things can show up 'time to time' - today was probably a bad day. What to do?

[Thomas coupling]

CAA take action if ectopics exceed 13% of your regular daily 84000 beats.
They also show a keen interest in couplets and triplets.
You cannot 'assume' you don't have CHD unless you do an angiogram. This is the gold standard. Even a radio isotope stress test won't confirm it!
Until/unless you have an angiogram, you will never get your restriction lifted.

British Guy - unless you can remove the threat of a LBBB, your restricted class 1.

[BritishGuy]

How do I go about removing the threat of a LBBB? I went to have a ultrasound of my heart and they said that the LBBB is there but at my age (early 30) is very insignificant. They said it maybe there today - and maybe not tomorrow. I think the CAA will issue me a restricted class 1 today, with the restriction on, which they'll 'review' in 3 years. Is it just a case of monitoring it for 3years then taking it off if everything stays normal?

[hughcant]

Thomas coupling - I think you were replying to my comment that my echo and stress ECG indicate that I do not have ischemic heart disease/CHD and that I would not get the OML lifted without an angiogram. As it happens, the CAA has informed me that it would consider lifting it "should the proportion of ectopics fall substantially". By this I take to mean that that is all I need to demonstrate i.e. a 24 ECG indicating less than 2% ectopics.

If you weren't referring to my post then I apologise for the mis-understanding.