Medical Mondays: What Pilots Need to Know About Congenital Heart Conditions
The FAA introduced a new disposition table for congenital heart conditions on June 24, 2026, changing how certain diagnoses are evaluated during aviation medical certification. Aviation attorney Matthew Bulow explains that pilots with an uncomplicated, uncorrected patent foramen ovale (PFO) who have no symptoms and require no treatment may be eligible to receive their medical certificate directly from an Aviation Medical Examiner (AME), provided there are no symptoms that could interfere with flight duties.
Pilots with a surgically closed atrial septal defect (ASD) or PFO generally need to have their applications deferred to the FAA for review. Required records may include a current cardiologist’s progress note, an echocardiogram, a 24-hour cardiac monitor and, if surgery occurred within the past five years, the operative report. More complex congenital heart conditions may require additional testing, such as an exercise stress test, records from all cardiac surgeries and actual images from advanced imaging studies. Pilots with coarctation of the aorta also need a brain MRA. The FAA reviews the submitted information to determine whether a medical certificate may be granted through Special Issuance.
Key Insights
- FAA Update: A new disposition table for congenital heart conditions was introduced on June 24, 2026.
- Uncorrected PFO: An AME may issue a certificate for an uncomplicated, asymptomatic PFO when no treatment is recommended and flight duties are not affected.
- Surgically Closed ASD or PFO: The application must be deferred to the FAA, with specified cardiology records and testing.
- Complex Conditions: Additional requirements may include stress testing, surgical records and actual CT or MRI images.
- Cardiologist Records: A current progress note from any board-certified cardiologist may satisfy the requirement if the original treating cardiologist is no longer involved.
- Special Issuance: The FAA reviews the submitted documentation and determines whether the pilot may qualify for certification.
