Cardiovascular

This regulation sets cardiovascular standards for first-class medical certificates (required for airline transport pilots). You cannot hold a first-class medical if you have a history or diagnosis of heart attack, angina, treated coronary heart disease, cardiac valve replacement, permanent pacemaker, or heart transplant.

Additionally, you must pass an electrocardiogram (EKG) screening at specific intervals: once after turning 35, then annually after turning 40. The EKG must be performed within 60 days before your medical application and follow acceptable standards.

These requirements are more stringent than second- or third-class medicals, reflecting the higher safety standards for commercial airline operations. If you have any of the disqualifying conditions, you would need a special issuance authorization from the FAA to potentially obtain certification, which involves additional medical evaluation and documentation.

*This is a plain-English summary for study only. The official 14 CFR text on this page is controlling — always read the current regulation and consult a CFI.*