What is the waiting period after a heart attack (MI) for a DOT physical?

The FMCSA requires a **mandatory waiting period of two months (60 days)** after a Myocardial Infarction (MI). After this period, you must provide a cardiologist clearance letter, results of a satisfactory Exercise Tolerance Test (ETT), and an Echocardiogram showing a Left Ventricular Ejection Fraction (LVEF) of 40% or greater to be certified for one year.

Can I get a DOT medical card if I have an Implantable Cardioverter Defibrillator (ICD)?

No. An **Implantable Cardioverter Defibrillator (ICD) is an automatic and permanent disqualification** for a DOT medical card. This is due to the underlying risk of sudden incapacitation (syncope) that the device is meant to treat.

What is the DOT physical waiting period after getting a coronary artery stent?

The minimum waiting period after a coronary artery stent (PCI/Angioplasty) is **one week (7 days)**. You must have clearance from your cardiologist to return to work, and you will be required to get a satisfactory Exercise Tolerance Test (ETT) within 3-6 months and then every two years thereafter.

Can I pass a DOT physical with a pacemaker?

Yes, having a pacemaker does not automatically disqualify you. However, you must wait **1 to 3 months** after implantation (depending on the indication) and provide documentation of your most recent annual pacemaker check (within 12 months) along with a cardiologist clearance letter confirming stability. Certification is typically limited to one year.

What documents do I need for my DOT exam if I’ve had bypass surgery (CABG)?

You need to complete a **3-month waiting period** and bring a clearance letter from your cardiologist confirming the sternum has healed and you are asymptomatic. You also need an Echocardiogram showing an LVEF of 40% or higher and a satisfactory Exercise Tolerance Test (ETT). Certification is limited to one year.

DOT Physical Heart Conditions: Waiting Periods for Stents, Bypass, Pacemakers, and Cardiologist Clearance in Charlotte, NC

DOT Physical Heart Conditions

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Quick Answer: Heart conditions require strict compliance with FMCSA waiting periods and mandated cardiology documentation. The shortest waiting period is 1 week (Stent), while a Heart Attack (MI) requires 2 months and Bypass Surgery (CABG) requires 3 months. An Implantable Cardioverter Defibrillator (ICD) is an automatic disqualification.

In This Guide:

Automatic Disqualification (ICD)
Mandatory Waiting Periods & Clearance
Pacemaker and Angina Rules
Required Cardiology Documentation Checklist

Automatic Disqualification: The Implantable Cardioverter Defibrillator (ICD)

The most definitive rule for cardiac devices involves the Implantable Cardioverter Defibrillator (ICD). This device is designed to treat life-threatening arrhythmias (irregular heartbeats) that can cause sudden incapacitation or syncope (fainting).

Immediate Disqualification Rule:Having an Implantable Cardioverter Defibrillator (ICD) is an automatic and permanent DOT disqualification under FMCSA regulations. Drivers with an ICD are considered a high risk for sudden cardiac events that compromise public safety.

FMCSA Mandatory Waiting Periods & Clearance Requirements

If you have had a remedial cardiac procedure, you must complete a strict minimum waiting period and provide specific documentation from your treating cardiologist before you can be certified for commercial driving.

Condition/Procedure	Minimum Waiting Period	Key Documentation Required for Certification
Coronary Artery Stent (PCI/Angioplasty)	1 Week (7 days)	Cardiologist Clearance Letter, Satisfactory Exercise Tolerance Test (ETT) 3–6 months post-procedure (then biennially).
Myocardial Infarction (MI) / Heart Attack	2 Months (60 days)	Cardiologist Clearance Letter, LVEF ≥ 40% (Echocardiogram), Satisfactory Exercise Tolerance Test (ETT).
Coronary Artery Bypass Graft (CABG)	3 Months (90 days)	Cardiologist Clearance Letter (confirming sternum healed), LVEF ≥ 40%, Asymptomatic, Satisfactory ETT.

For all conditions listed above, the maximum certification period is 1 Year (annual recertification is required).

Pacemaker and Angina Rules

Two other common cardiac conditions have specific, but certifiable, standards:

Pacemakers (Non-Defibrillators)

A pacemaker alone is not disqualifying. The focus is on the underlying condition and the device’s stability.

Waiting Period: 1–3 months after implantation (depending on the reason).
Required Documents: A cardiologist clearance letter, and documentation of the most recent annual pacemaker check (must be dated within the last 12 months).
Certification: Limited to a 1-year card with annual cardiology follow-up.

Q: Can I be certified if I have stable angina (chest pain)?

A: Yes. If your angina is confirmed to be stable by your cardiologist (meaning no pain at rest and no change in the pattern of pain for at least 3 months), and you have provided a satisfactory stress test, you can be certified for up to 1 year.

Required Cardiology Documentation Checklist

To avoid a Determination Pending status and ensure your certification goes smoothly in Charlotte, you must bring the following documentation to your exam:

A Clearance Letter from your Cardiologist (must state that you are medically optimized and safe to operate a CMV).
Results from a recent Echocardiogram (showing your Left Ventricular Ejection Fraction, or LVEF, is 40% or greater).
A recent Exercise Tolerance Test (ETT) or Stress Test report (validity varies from 3 months to 2 years, depending on the condition).
A complete, legible list of all current heart-related medications and dosages.

Have Complex Heart Condition Documentation? Get Certified by an FMCSA Expert.

Don’t risk disqualification due to missing paperwork. Our FMCSA-Certified Medical Examiner is an expert in complex cardiovascular clearance requirements.

Examiner: Dr. Lemuel P. Byrd, Jr., D.C.

Call Now: 704-544-3494

Hours: Monday-Friday 9am-5pm | Saturday 9am-12pm
Location: 8415 Pineville-Matthews Road, Suite 102, Charlotte, NC 28226
Cost: $70 | No Wait Policy | Walk-ins & Appointments Welcome