Toprol

[pilot4500]

During my last FAA First Class physical, my AME said that my blood pressure and pulse was elevated. It was within limits but higher than normal. He deferred my medical and told me to see a Cardiologist. I have made 2 visits to a Cardiologist and he performed an EKG, Sauna gram, and a Stress Echo test. Everything looked normal but my resting heart rate was still high. It was between 100 and 110. My blood pressure was also elevated. Not dangerously so, but higher than normal for someone of my age. I am 31 years old.

My Cardiologist put me on a beta blocker, 50 mg of Toprol. I am following up with him in a few days just to check my pulse and blood pressure again and see how I am reacting to the medicine. He will be sending all of my test results to my AME. If everything is normal, will this medication cause my medical to be denied?

 

[My Flight Surgeon]

No, it will not.

Did he check your thyroid??

 

[pilot4500]

No, it will not.

Did he check your thyroid??

Yes he did check my thyroid. All of my thyroid functions were normal.

 

[My Flight Surgeon]

Just take the records to the AME.

 

[pilot4500]

Thank you for the advice Doctor. I took the records to my AME and my new First Class Medical certificate was issued. My AME had to consult with the FAA and they insisted that some limitations be placed on it. My medical is not valid for any class after one year, and in one week I have to go get a blood pressure and pulse check. If my pulse and blood pressure are controlled well within limits while I am on the Toprol, do you think that I could have a problem renewing my medical after one year? My AME said that the FAA was reluctant to allow the certificate to be issued, despite the fact that I had over 30 pages of records showing normal heart function from my Cardiologist.

 

[My Flight Surgeon]

If things remain stable, I would expect they will renew it in a year.

 

[pilot4500]

If things remain stable, I would expect they will renew it in a year.

That is good to hear. This was the first time that I had any kind of hiccup getting a medical. I guess I am just getting older.

 

[bc2209]

Pilot4500 I'm confused here. If your blood pressure and pulse were in normal limits, why would he defer the medical and make you see a cardiologist? Additionally why would the FAA be reluctant to issue if you were in fact in "normal limits". This raises concern as I do have higher than normal blood pressure.

 

[pilot4500]

Pilot4500 I'm confused here. If your blood pressure and pulse were in normal limits, why would he defer the medical and make you see a cardiologist? Additionally why would the FAA be reluctant to issue if you were in fact in "normal limits". This raises concern as I do have higher than normal blood pressure.

I think that a lot of things are left at the discretion of the AME. My blood pressure was within the FAA prescribed limit, but at the upper end of the limit. As far as I know, there isn't a maximum limit set for a pulse. The AME still felt that my blood pressure and pulse were causes for concern and did not feel comfortable issuing a medical without me seeing a Cardiologist. After being put on medication, doing several tests, and getting a clean bill of health from the Cardiologist, the AME seemed satisfied that I was safe to fly. He still had to consult with the FAA. I don't know why, but he did. I guess all of the tests that I had done raised a lot of concerns, hence the fact that my medical is only valid for one year.

If you have high blood pressure, I would recommend getting that under control before you go for your aviation medical exam. I would hate for anyone to have to go through what I went through, especially without health insurance. Seeing a Cardiologist is not cheap!

 

[bc2209]

OK thanks for the information. Much appreciated.

 

[My Flight Surgeon]

The upper limit for pulse is 100 without an evaluation.

 

[pilot4500]

I saw my AME for a required follow up visit. My resting pulse was down to 72, so that is a big improvement. The Toprol seems to be helping a lot there. My blood pressure was 138/92. I know that is not ideal but as far as I know, it is within FAA limits. When I visited my Cardiologist, it was 118/86, and that was documented in a letter to the AME. I was a bit anxious when I visited my AME so that could have been a factor.

My AME still wants me to see him for another checkup in two weeks. Is this normal considering that he has already issued my First Class Medical with a one year restriction on it? Could my medical be revoked if I don't see him for a follow up? I am uninsured and these follow up visits are not cheap.

 

[My Flight Surgeon]

He is just providing good quality care for your blood pressure.