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Army Aviation Medical Standards
Heart and vascular system
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The below disqualifying conditions are in addition to the disqualifying conditions listed in the Military Medical Accessions Medical Guide. Unlike medical waivers to join the military, medical waivers for aviation duty are much harder to come by.

The causes for medical unfitness for flying duty Classes 1/1A/2/2F/2S/3 are:

a. History of any abnormal electrocardiographic findings, including but not limited to:

(1) Left axis deviation greater than minus 45 degrees.

(2) Acquired right axis deviation greater than 120 degrees.

(3) First degree AV-block when the PR interval (interval between the P and R waves on an electrocardiogram (EKG)) cannot be shortened to less than or equal to 220 milliseconds in the unipolar leads during exercise.

(4) Mobitz Type II second degree AV block, and third degree AV block.

(5) Acquired left anterior or posterior hemiblock.

(6) Acquired complete right bundle branch block.

(7) Complete left bundle branch block.

(8) Pre-excitation as manifested by Wolff-Parkinson-White pattern or short PR interval (PR interval less than 120 milliseconds in all 12 leads). Wolff-Parkinson-White syndrome.

(9) Sinus pause or asystole accompanied by symptoms and/or greater than 2.2 seconds in duration.

(10) Bradydysrhythmias accompanied by symptoms and/or hypotension.

(11) Supraventricular tachycardia (3 or more beats at a rate greater than 100) to include atrial fibrillation/flutter, multifocal atrial tachycardia, junctional tachycardia, and persistent sinus tachycardia.

(12) Frequent uniform or multiform ventricular premature beats, or ventricular premature beats, or ventricular premature beat pairs, as defined by APL, Abnormal Electrocardiogram.

(13) Ventricular tachycardia (3 or more beats at a rate greater than 100), to include ventricular fibrillation/flutter and accelerated idioventricular rhythm.

(14) Acquired ST and T wave abnormalities consistent with myocardial dysfunction of any etiology.

(15) Aeromedically borderline abnormal or abnormal exercise treadmill test as defined by ATB 6, Aeromedical Graded Exercise Test, until reviewed by the Aviation Medicine Approving Authority.

b. History of hypertrophic, dilated, or obstructive cardiomyopathy, to include left ventricular hypertrophy, as documented by clinical or EKG evidence. Hypertrophy due to athletic heart is not disqualifying.

c. History of valvular heart disease, to include mitral valve prolapse, as documented by clinical or electrocar­diographic findings.

d. History of myocarditis, or endocarditis, to include subacute bacterial endocarditis. History of pericarditis until reviewed by the Aviation Medicine Approving Authority.

e. Any evidence of coronary artery disease as outlined by APL, Aeromedical Cardiovascular Screening Program.

f. For Classes 2/2F, suspected coronary artery disease such as an elevated cardiac risk index, elevated total cholesterol or cholesterol/high-density lipoprotein (HDL) -cholesterol ratio in conjunction with an abnormal aeromedi­cal graded exercise treadmill test and/or abnormal cardiac fluoroscopy as outlined in APL, Aeromedical Cardiovascular Screening Program.

g. History of congenital anomalies of the heart or great vessels, or surgery to correct these anomalies.

h. History of cor pulmonale or congestive heart failure.

i. History of hypertension with a systolic pressure of 140 mmHg or greater, and/or diastolic pressure of 90 mmHg or greater, with or without systemic complications confirmed by average reading of a 3-day blood pressure check. (See APL, Hypertension in Aircrew Members.)

j. Orthostatic hypotension or orthostatic intolerance or symptomatic hypotension. (See para 4–22e.)

k. History of diseases of the blood and lymphatic vessels, to include but not limited to, aortic aneurysm, arterioscle­rotic occlusive disorders, fistulas, vasculitis, vasospastic disorders, thromboembolic disorders, and lymphedema.

l. History of any cardiac surgical procedure, to include pacemaker insertion, valve replacement, bypass tract ablation by any method, coronary angioplasty, and coronary artery bypass.

Flight Classes

Specific Flight Class Medical Examinations are:

Class 1 - Warrant Officer Aviation Duty Applicants
Class 1A - Commissioned Officer Aviation Duty Applicants
Class 2 - Current Aviators, Current Student Aviators, and Previous Aviators Returning to Aviation Service
Class 2F - Flight Surgeons, Including Those in Flight Surgeon Training
Class 2S - MOS 13F, Assigned to Aerial Fire Support Observer Duty
Class 3 - Non Rated Soldiers who Participate in Regular Flights (Crew Chiefs, Gunners, UAV Operators, etc.)
Class 4 - Air Traffic Control

Derived from Army Regulation 40-501, Standards of Medical Fitness

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