Mitral Valve Prolapse

[troopernflight]

Dr. Forred,
A couple of weeks ago I went to get my 1st class medical certificate for the first time. I had no problems and the flight surgeon issued the certificate with no restrictions. I noticed in the past few weeks that I would get heart palpitations periodically that would last a few seconds. (usually after I drank a lot of coffee). I went to my regular doctor to get it checked out and he said he heard the "click" that indicated that I might have Mitral Valve Prolapse. He then did an EKG. He stared at the print out for about 5 minutes and then said that he noticed a slight irregular heart beat but wasn't sure whether it was a problem or just an anomoly. He wants me to get a heart echo next month to make sure everything is ok. He said he doesn't see it being a problem with my flight certificate. Do you have any input as to this affecting my ticket?
Thanks, Dan

[Qgar]

I had the same thing happen to me. I had the echocaradiogram and a stress test. Turns out it wasn't mitral-valve. I just had to cut back on the caffeine. Good luck! Those palpitations are scary though, aren't they?

[My Flight Surgeon]

Originally Posted by troopernflight

Dr. Forred,
A couple of weeks ago I went to get my 1st class medical certificate for the first time. I had no problems and the flight surgeon issued the certificate with no restrictions. I noticed in the past few weeks that I would get heart palpitations periodically that would last a few seconds. (usually after I drank a lot of coffee). I went to my regular doctor to get it checked out and he said he heard the "click" that indicated that I might have Mitral Valve Prolapse. He then did an EKG. He stared at the print out for about 5 minutes and then said that he noticed a slight irregular heart beat but wasn't sure whether it was a problem or just an anomoly. He wants me to get a heart echo next month to make sure everything is ok. He said he doesn't see it being a problem with my flight certificate. Do you have any input as to this affecting my ticket?
Thanks, Dan

It depends on what the ECHO shows. If it is a mitral valve prolapse, no big deal. That is the most likely thing to be there if there is anything.

As a side note, "regular doctors" don't know anything about the FAA regulations and guidelines. This is a recurring problem the FAA sees all of the time.

[troopernflight]

Thanks for the help. I'm sure I speak on everyone's behalf is saying that you are a greatly appreciated resource on this site.

[troopernflight]

One follow-up question about taking blood pressure.... You may have answered this before but I couldn't find it. Can you have your BP taken when laying on your back? When I use my home tester when seated it always gives me a somewhat high reading. When I lay down it gives me a perfect reading. For future reference, is laying down permissable?

[My Flight Surgeon]

Th correct way according to the National Institutes of Health.

Accurate Blood Pressure Measurement in
the Office
The accurate measurement of BP is the sine qua
non for successful management. The equipment—
whether aneroid, mercury, or electronic—should
be regularly inspected and validated. The operator
should be trained and regularly retrained in
the standardized technique, and the patient must
be properly prepared and positioned.4,56,57 The
auscultatory method of BP measurement should
be used.58 Persons should be seated quietly for at
least 5 minutes in a chair (rather than on an exam
table), with feet on the floor, and arm supported
at heart level. Caffeine, exercise, and smoking
should be avoided for at least 30 minutes prior to
measurement. Measurement of BP in the standing
position is indicated periodically, especially in
those at risk for postural hypotension, prior to
necessary drug dose or adding a drug, and in
those who report symptoms consistent with
reduced BP upon standing. An appropriately
sized cuff (cuff bladder encircling at least 80 percent
of the arm) should be used to ensure accuracy.
At least two measurements should be made
and the average recorded. For manual determinations,
palpated radial pulse obliteration pressure
should be used to estimate SBP—the cuff should
then be inflated 20–30 mmHg above this level for
the auscultatory determinations; the cuff deflation
rate for auscultatory readings should be 2 mmHg
per second. SBP is the point at which the first of
two or more Korotkoff sounds is heard (onset of
phase 1), and the disappearance of Korotkoff
sound (onset of phase 5) is used to define DBP.
Clinicians should provide to patients, verbally and
in writing, their specific BP numbers and the BP
goal of their treatment.

Blood pressure will go down when you lie down and relax. We never take it lying in the office though.