OPAM Workshop: DOT FMCSA NRCME Course-263074

263074 - Article 19

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This document is a form for cardiologists to evaluate and provide necessary information for patients applying or renewing a Commercial Driver’s License (CDL) who have a history of specific cardiovascular conditions such as stents, myocardial infarction (MI), or angina. The form requires confirmation on several health metrics, which include:<br /><br />- The patient being asymptomatic, tolerating medications, and listing those medications.<br />- A satisfactory exercise tolerance test (ETT) result being provided.<br />- A resting left ventricular ejection fraction (LVEF) of at least 40%, with documentation to support this measurement.<br />- No ischemic changes on an electrocardiogram, with supporting documentation.<br /><br />There are specific criteria depending on the time since an MI event, angina history, presence of ischemic ECG changes, and tolerance to cardiovascular treatments. For recertification after a Percutaneous Coronary Intervention (PCI) with stents, criteria include at least a week post-procedure, approval from the cardiologist, and medication tolerance. An ETT should be conducted 3-6 months after a PCI.<br /><br />Moreover, the document stipulates that annual evaluations and biennial ETTs are required, with additional imaging stress tests if results are inconclusive. A low risk of sudden incapacitation while driving is emphasized, alongside recommendations from the cardiologist. The form requires confirmation that the patient can achieve specific exercise goals, such as reaching a workload capacity over 6 METs, maintaining heart rate criteria, experiencing a systolic blood pressure rise, and having no significant ST-segment depression during the exercise. <br /><br />The overall intention is to ensure cardiovascular safety and competency to handle the physical demands of commercial driving.

Keywords

cardiologists

Commercial Driver’s License

cardiovascular conditions

myocardial infarction

exercise tolerance test

left ventricular ejection fraction

electrocardiogram

Percutaneous Coronary Intervention

medication tolerance

sudden incapacitation