FAR 67.211 — Second-Class Cardiovascular Standards
FAR 67.211 sets cardiovascular standards for a second-class medical certificate, listing disqualifying heart conditions like MI, angina, and pacemakers.
FAR 67.211 lays out the cardiovascular standards you must meet to hold a second-class medical certificate — the medical required for commercial pilot privileges. To qualify, you must have no established medical history or clinical diagnosis of any of the following conditions:
- Myocardial infarction (heart attack)
- Angina pectoris (chest pain from reduced blood flow to the heart)
- Coronary heart disease that has required treatment, or that — if untreated — has been symptomatic or clinically significant
- Cardiac valve replacement
- Permanent cardiac pacemaker implantation
- Heart replacement (transplant)
Why it matters operationally: commercial flying places higher demands on a pilot, and a sudden cardiac event in flight could be catastrophic for crew, passengers, and people on the ground. If you have one of these conditions, you are not automatically grounded forever — but you cannot be issued a second-class medical under the standard rules. You would need to pursue a Special Issuance Authorization from the FAA, which requires detailed cardiac evaluation and ongoing follow-up.