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Third-Class Medical Cardiovascular

FAR 67.311 — Third-Class Medical Cardiovascular

FAR 67.311 lists cardiovascular conditions disqualifying for a third-class medical, including heart attack, angina, pacemaker, and valve replacement.

In Plain English

FAR 67.311 sets the cardiovascular standards for a third-class airman medical certificate — the medical most student and private pilots hold. 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 heart blood flow)
  • Coronary heart disease that has required treatment, or — if untreated — has been symptomatic or clinically significant
  • Cardiac valve replacement
  • Permanent cardiac pacemaker implantation
  • Heart replacement (transplant)

Why it matters: the FAA wants to minimize the risk of sudden incapacitation in flight. If you have one of these conditions in your medical history, you are not automatically grounded — you may still qualify through a Special Issuance authorization under FAR 67.401, which requires additional medical documentation and FAA review. Disclose any cardiac history honestly on MedXPress before your AME exam.

Regulation Text
14 CFR § 67.311
§ 67.311 Cardiovascular. Cardiovascular standards for a third-class airman medical certificate are no established medical history or clinical diagnosis of any of the following: (a) Myocardial infarction; (b) Angina pectoris; (c) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (d) Cardiac valve replacement; (e) Permanent cardiac pacemaker implantation; or (f) Heart replacement.
Oral Exam Questions a DPE Might Ask
Q1What cardiovascular conditions disqualify an applicant from a third-class medical certificate?
Per FAR 67.311, an applicant cannot have an established history or diagnosis of myocardial infarction, angina pectoris, symptomatic or treated coronary heart disease, cardiac valve replacement, permanent pacemaker implantation, or heart replacement.
Q2If you had a heart attack five years ago, can you ever fly again under a third-class medical?
Not under the standard issuance — FAR 67.311(a) lists myocardial infarction as disqualifying — but you may still be eligible through a Special Issuance Authorization from the FAA after submitting required cardiac evaluations.
Q3Does having a permanent pacemaker automatically disqualify a third-class medical applicant under FAR 67.311?
Yes, FAR 67.311(e) lists permanent cardiac pacemaker implantation as a disqualifying condition for a third-class medical, though a Special Issuance may still be pursued through the FAA.
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Including medical certificates
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Related Sections in Part 67
§ 67.1
Medical Certificate Applicability
§ 67.101
First-Class Medical Eligibility
§ 67.103
First-Class Medical Eye Standards
§ 67.105
First-Class Medical ENT Standards
§ 67.107
First-Class Medical Mental Standards
§ 67.109
First-Class Medical Neurologic Standards
§ 67.111
First-Class Medical Cardiovascular
§ 67.113
First-Class Medical Standards
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FAR 67.311 — Third-Class Medical Cardiovascular Rules