Post Angioplasty/Stent procedure.

[ooizcalling]

Greetings all. Back in January I had a stent put in one artery (LED) of the heart following detection by an observant cardiologist of less than normal oxygen supply to the heart muscles during a stress ECG (for which I am very gratefull as I had no symptoms indicating any abnormality). Now I'm going through the process of reissuing my medical. The requirement attached to the reissue requires further 6 monthly stress ECG, blood tests, control analysis, etc etc and my medical certificate has the qualification "FOR CASA AUDIT" entered on it (CASA being the Australian aviation authority). I hate seeing any limitations entered on an aviation medical certificate as it may be seen as a disadvantage in the job market. Furthermore, I think it should remain private, ie. between the AME, CASA, and the affected person and not stated on a public ducument visible to and assesable by a layman. It also seems to be a bit over the top as all other heart factors are excellent as was the reports from every cardiac specialist that I saw. So my question is to those who've gone through this procedure in the past. At your first medical after the procedure and thereafter, what limitations were placed on your medical examinations for further renewal of your medical certificate and was there any entry on your medical certificate stating this ?
Thanks.

[Dale Hardale]

Sorry to disappoint you but CASA will probably continue this 'FOR CASA AUDIT" on your medical for quite some time.

I had a stent inserted 5 years ago - each time I go back to the cardiologist to do the stress ECG etc etc, he wants to know why I am doing it. There is absolutely nothing abnormal at all in any of the test I have done.

CASA has some fairly restrictive guidelines that are increasingly out of date with technology. :mad:

Having said this, it was a routine medical that picked up the problem, and in any other profession that does not require a medical, probably would have led to a heart attack if it was not fixed.:ok:

[homonculus]

Hi

Can't help you with the regulatory side but although you don't say why you had the stress ECG it may be worth considering what happened after and why

Not sure your cardiologist was particularly observant - the ECG was abnormal and this meant there was a risk of lack of blood to part of your heart which results in a heart attack or worse. If he had missed it he would have been a bit of a @@@@@@

The stent jumps the narrowing to restore blood flow distal or downstream to the narrowing

So far so good

The problem is the stent can block so the problem recurs. You have a problem with the blood supply to your heart and there is thus a risk of a heart attack - hopefully less than before the stent but this is why the regulator is cautious

Cardiologists basically manage damaged valves, arrhythmias and these blood supply problems. Not much else goes wrong in adults. So while your cardiologist is happy with 'everything else' it means the valves, rhythms and other blood vessels are OK.

Bottom line - your problem was picked up before it did any harm and you may well to live to be 100 but you do have coronary artery disease and so your risk has not returned to that of someone without disease. Your fellow pilots may have the same problem but be undiagnosed and at similar risk but sadly that doesn't stop the regulator putting you under the microscope