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As a medical examiner, it is your decision whether the nature and severity of the condition of the driver will result in sudden incapacitation. The major clinical manifestations of coronary heart disease (CHD) are acute myocardial infarction, angina pectoris (either stable or unstable), congestive heart failure, and sudden death.
Sudden death occurs when an individual goes from a usual state of health to death within 1 hour. In some cases, those who suffer sudden death are asymptomatic with the first symptom of CHD being sudden death.
The incidence of crashes caused by sudden death is relatively low, primarily because of the length of time between the onset of the cardiovascular event and the incapacitation of the driver. Therefore, it is important that you educate the driver about warning signs of an impending CHD event. Emphasize that the driver may have only a short time following the onset of symptoms to safely stop the vehicle and call for medical assistance.
Prognostic indicators for CHD
The major predictor of CHD is left ventricular function. Other indicators to be considered include:
- General heath.
- Age.
- Arrhythmias.
- Angina pectoris.
- Associated vascular disease.
- Severity of CHD.
General CHD recommendation summary
The qualified driver with CHD should:
- Secure clearance from a cardiovascular specialist who understands the functions and demands of commercial driving.
- Tolerate cardiovascular medication and be:
- Knowledgeable about medications used while driving.
- Free from side effects that compromise driving ability.
- Compliant with the ongoing treatment plan.
The following link to select CHD Guidance/Advisory Criteria key points:
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