medical question: childhood heart murmur

[[email protected]]

Okay, here's an odd situation.

30-something pilot, been flying a few years, have had a couple of class
III medical examinations; no problems.

On a recent visit home, pilot's family remind him that as infant he had
a heart murmur. There were checkups for a few years, but no
restrictions, meds, problems, etc of any sort.

Pilot vaguely remembers some of this on being reminded, but also knows
he's never mentioned it to an AME. (As far as he knows, there's no
murmur today; at least no doctor or AME has mentioned it during an exam
in the last 20 years.)

Pilot has a one year old medical good for two more years.

1. does the pilot divulge to FAA said childhood murmur?
2. if so, to whom? AME? Oklahoma City?
3. does he wait until next exam (couple of years) or do so now?
4. If going to divulge, should he go get fancy/expensive tests *first*
or let FAA or AME ask for said tests?

Some seriously Googling about murmurs shows the protocol for murmurs to
be that they are FAA disqualifying until shown to be benign, and the
FAA has a list of stuff they want a cardiologist to provide to make the
decision. It's not clear if the AME or OKC needs to do that. The list
of stuff is long: stress test, ekg, family history, etc.


this unnamed flyer is a little freaked out right now. he doesn't want
to break the law, but doesn't want to give up his one true love,
flying!

thanks,
unnamedflyer

[Denny]

TROLL! shame on you...

[Dave S]

Any AME worth his salt can detect a "detectable" heart murmer on
listening to the chest of an applicant.

If the murmer is no longer present, then your outgrew the condition. If
as a child you didn't require treatment, then likely as an adult you
dont either. If its not causing you symptoms, its a "non issue". As a
child a murmer is not uncommon, and many outgrow it as the heart grows

Would I disclose a transient childhood condition that is no longer
pertinent? Nope.

My take on it is, if its no longer present then its CLEARLY benign :)

If a new murmer develops it is likely because of a newly developed
structural problem: cardiomegaly, infarction, etc.. and those new
structural problems need to be evaluated properly with the million
dollar workup decribed below (echo, stress test, possible cardiac cath).

Keep in mind I am not an AME nor a cardiologist, just an ICU and ER
nurse who deals with lots of cardiac patients.

Dave

wrote:
> Okay, here's an odd situation.
>
> 30-something pilot, been flying a few years, have had a couple of class
> III medical examinations; no problems.
>
> On a recent visit home, pilot's family remind him that as infant he had
> a heart murmur. There were checkups for a few years, but no
> restrictions, meds, problems, etc of any sort.
>
> Pilot vaguely remembers some of this on being reminded, but also knows
> he's never mentioned it to an AME. (As far as he knows, there's no
> murmur today; at least no doctor or AME has mentioned it during an exam
> in the last 20 years.)
>
> Pilot has a one year old medical good for two more years.
>
> 1. does the pilot divulge to FAA said childhood murmur?
> 2. if so, to whom? AME? Oklahoma City?
> 3. does he wait until next exam (couple of years) or do so now?
> 4. If going to divulge, should he go get fancy/expensive tests *first*
> or let FAA or AME ask for said tests?
>
> Some seriously Googling about murmurs shows the protocol for murmurs to
> be that they are FAA disqualifying until shown to be benign, and the
> FAA has a list of stuff they want a cardiologist to provide to make the
> decision. It's not clear if the AME or OKC needs to do that. The list
> of stuff is long: stress test, ekg, family history, etc.
>
>
> this unnamed flyer is a little freaked out right now. he doesn't want
> to break the law, but doesn't want to give up his one true love,
> flying!
>
> thanks,
> unnamedflyer
>

[Mortimer Schnerd, RN]

Dave S wrote:
> Keep in mind I am not an AME nor a cardiologist, just an ICU and ER
> nurse who deals with lots of cardiac patients.


Then you should look at the subject line to see how the word is spelled. I hope
you don't write "murmer" on charts.



--
Mortimer Schnerd, RN

[Gary Drescher]

> wrote in message
oups.com...
> 1. does the pilot divulge to FAA said childhood murmur?
> 2. if so, to whom? AME? Oklahoma City?

There's no obligation to do so before the next AME exam.

> 3. does he wait until next exam (couple of years) or do so now?
> 4. If going to divulge, should he go get fancy/expensive tests *first*
> or let FAA or AME ask for said tests?

If the condition only occurred during infancy, the pilot might well forget
about it again by the time of his next exam. You're only required to report
what you remember.

--Gary

[Dave S]

Congrats Mort... thats my first mispelling someone has kicked back on me
in over a year.


Thanks for playing.
Dave

Mortimer Schnerd, RN wrote:
> Dave S wrote:
>
>>Keep in mind I am not an AME nor a cardiologist, just an ICU and ER
>>nurse who deals with lots of cardiac patients.
>
>
>
> Then you should look at the subject line to see how the word is spelled. I hope
> you don't write "murmer" on charts.
>
>
>

[Mortimer Schnerd, RN]

Dave S wrote:
> Congrats Mort... thats my first mispelling someone has kicked back on me
> in over a year.
>
>
> Thanks for playing.


We ame to pleeze.



--
Mortimer Schnerd, RN

[Peter Duniho]

"Gary Drescher" > wrote in message
...
> If the condition only occurred during infancy, the pilot might well forget
> about it again by the time of his next exam. You're only required to
> report what you remember.

That's an interesting take on the regulations. Where'd you get that from?

As far as I know, you're required to report everything. If you can't
remember, you'd better keep records. As I get older the "have you ever..."
checkboxes are getting filled up, with a lot of them being "previously
reported". I keep my copy of the previous application so I don't miss
anything (thankfully the medical form includes a carbon copy for the
application now).

If you can cite the rule that says you only have to report what you
remember, sure would save me a lot of trouble.

Pete

[Gig 601XL Builder]

"Peter Duniho" > wrote in message
...
> "Gary Drescher" > wrote in message
> ...
>> If the condition only occurred during infancy, the pilot might well
>> forget about it again by the time of his next exam. You're only required
>> to report what you remember.
>
> That's an interesting take on the regulations. Where'd you get that from?
>
> As far as I know, you're required to report everything. If you can't
> remember, you'd better keep records. As I get older the "have you
> ever..." checkboxes are getting filled up, with a lot of them being
> "previously reported". I keep my copy of the previous application so I
> don't miss anything (thankfully the medical form includes a carbon copy
> for the application now).
>
> If you can cite the rule that says you only have to report what you
> remember, sure would save me a lot of trouble.
>
> Pete

The bottom of the form says, "... are true to the best of my knowledge..."
so he was OK until he was reminded of the problem.

I think I have an idea for a T-Shirt for pilots to where to family
gatherings.

"Feel free to tell me how cute I was as a baby just not how sick I was."

[George Patterson]

wrote:
>
> 1. does the pilot divulge to FAA said childhood murmur?

I would not do so.

The first time your friend filled out the form, there were a bunch of questions
that he answered. Truthfully, as far as he knew. He signed a statement to the
effect that they were true as far as he knew. From this point on, the AME asks
about changes to existing conditions or new conditions that have come up. You
friend can truthfully report those. The fact that he's now been told of an old
condition that seems to have disappeared doesn't change any existing conditions
or change the fact that he told the truth as far as he knew at the time.

In addition, there is one case of which I've read in which a pilot had his
certificate suspended for "falsifying an entry" in his logbook. He was up for
examination for a new rating, the examiner told him that he couldn't record the
time detailed in the entry for some reason, so he changed the entry in the
presence of the examiner. It was stated at the hearing that he would not have
been violated if he had refused to change the entry.

This situation might or might not get handled similarly, but I think it is
indicative of the way the FAA thinks on these matters. Saying "whoops! I forgot
about this one" might get your friend prosecuted for perjury on the original form.

George Patterson
Give a person a fish and you feed him for a day; teach a person to
use the Internet and he won't bother you for weeks.

[[email protected]]

Here's one response thanking several people who wrote comments.

This unnamed pilot, talked to the AOPA medical people (Jo Ann) this
morning, and they she recommended that there was no need to divulge
this condition. Specifically, she said that childhood murmurs are
common and most children grow out of them. If in two medical exams two
different AMEs never heard anything, then there is no reportable
murmur.

I dunno..... to be honest, though having my certificates revoked is a
highly unpleasant thought, what upsets me the most is the idea that in
an accident some day in the future the insurance company will go
looking for reasons not to pay, and find one... a non-relevant
technicality, but a reason nontheless.

Thanks again, people. I (I mean, my pilot friend, ;) will try not to
worry about it now.

What would be cool would be if you could anonymously talk to someone in
Oklahoma, like the AOPA medical advice people, but more likely to know
what the FAA medical people are thinking right now.

-unnamedpilot

[Montblack]

("Gig 601XL Builder" wrote)
[snip]
> "Feel free to tell me how cute I was as a baby just not how sick I was."


"I have no specific recollection"

This one seems to work.


Montblack

[Gary Drescher]

"Gig 601XL Builder" <wr.giacona@coxDOTnet> wrote in message
news:aKrIe.3509$_t.1964@okepread01...
> "Peter Duniho" > wrote in message
> ...
>> "Gary Drescher" > wrote in message
>> ...
>>> You're only required to report what you remember.
>>
>> If you can cite the rule that says you only have to report what you
>> remember, sure would save me a lot of trouble.
>
> The bottom of the form says, "... are true to the best of my knowledge..."

Right. If the FAA wanted our medical reporting to be more rigorous, they
could require us to keep a running log of reportable medical events, just as
we're required to log e.g. sufficient flight experience for currency, rather
than just relying on memory if challenged. But we're not required to keep
such a medical log (though of course we can if we want to).

Obviously, we could not credibly claim to have forgotten recent major
developments, if later questioned about them. But it's certainly plausible
to forget about an early-childhood heart murmur.

--Gary

[Gary Drescher]

"George Patterson" > wrote in message
news:B5sIe.42$zX3.24@trndny05...
> wrote:
> The first time your friend filled out the form, there were a bunch of
> questions that he answered. Truthfully, as far as he knew. He signed a
> statement to the effect that they were true as far as he knew. From this
> point on, the AME asks about changes to existing conditions or new
> conditions that have come up.

No, that's not the case. Each time you fill out the form, you're asked to
report 1) all health-professional visits within the last three years; and 2)
whether you have *ever in your life* had or been diagnosed with any of
several enumerated conditions. There's nothing that restricts the scope of
the questions to changes since the last exam.
(http://www.aopa.org/members/files/medical/8500-8.pdf)

--Gary

[Peter Duniho]

"Gig 601XL Builder" <wr.giacona@coxDOTnet> wrote in message
news:aKrIe.3509$_t.1964@okepread01...
> The bottom of the form says, "... are true to the best of my knowledge..."
> so he was OK until he was reminded of the problem.

Hmmm...well, the FAA isn't well-known for their propensity to allow "I
forgot" as an excuse. I'm looking for something a little more concrete than
the signature line of the form, thanks.

[Steve Foley]

My guess is that the doctor confused him with his brother.
The pilot's vague memories are probably regarding his brother.

> wrote in message
oups.com...
>
> Okay, here's an odd situation.
>
> 30-something pilot, been flying a few years, have had a couple of class
> III medical examinations; no problems.
>
> On a recent visit home, pilot's family remind him that as infant he had
> a heart murmur. There were checkups for a few years, but no
> restrictions, meds, problems, etc of any sort.
>
> Pilot vaguely remembers some of this on being reminded, but also knows
> he's never mentioned it to an AME. (As far as he knows, there's no
> murmur today; at least no doctor or AME has mentioned it during an exam
> in the last 20 years.)
>
> Pilot has a one year old medical good for two more years.
>
> 1. does the pilot divulge to FAA said childhood murmur?
> 2. if so, to whom? AME? Oklahoma City?
> 3. does he wait until next exam (couple of years) or do so now?
> 4. If going to divulge, should he go get fancy/expensive tests *first*
> or let FAA or AME ask for said tests?
>
> Some seriously Googling about murmurs shows the protocol for murmurs to
> be that they are FAA disqualifying until shown to be benign, and the
> FAA has a list of stuff they want a cardiologist to provide to make the
> decision. It's not clear if the AME or OKC needs to do that. The list
> of stuff is long: stress test, ekg, family history, etc.
>
>
> this unnamed flyer is a little freaked out right now. he doesn't want
> to break the law, but doesn't want to give up his one true love,
> flying!
>
> thanks,
> unnamedflyer
>

[Gig 601XL Builder]

"Peter Duniho" > wrote in message
...
> "Gig 601XL Builder" <wr.giacona@coxDOTnet> wrote in message
> news:aKrIe.3509$_t.1964@okepread01...
>> The bottom of the form says, "... are true to the best of my
>> knowledge..." so he was OK until he was reminded of the problem.
>
> Hmmm...well, the FAA isn't well-known for their propensity to allow "I
> forgot" as an excuse. I'm looking for something a little more concrete
> than the signature line of the form, thanks.
>

How could someone be required to report something they have no knowledge of?

[George Patterson]

Peter Duniho wrote:
>
> Hmmm...well, the FAA isn't well-known for their propensity to allow "I
> forgot" as an excuse.

True, but in this case, the pilot apparently was too young at the time to even
remember that the problem existed (the OP says he was an infant). If it even
*did* exist. All we have here is relatives' possibly incorrect memories of a
possibly incorrect diagnosis of a possibly non-existent condition that required
no treatment and does not exist today. "I was unaware of this" is vastly
different from "I forgot."

If I were inclined to report it (and, as I said, I would not do so), I would
first get my hands on the examining doctor's old records and see what actually
happened. If I couldn't get copies of those records, neither can anyone else,
and it "didn't happen."

George Patterson
Give a person a fish and you feed him for a day; teach a person to
use the Internet and he won't bother you for weeks.

[Peter Duniho]

"Gig 601XL Builder" <wr.giacona@coxDOTnet> wrote in message
news:XzuIe.3518$_t.2031@okepread01...
> How could someone be required to report something they have no knowledge
> of?

The same way they are required to be familiar with ALL available information
pertaining to a flight.

[Peter Duniho]

"George Patterson" > wrote in message
news:00vIe.14421$2y2.782@trndny02...
> True, but in this case, the pilot apparently was too young at the time to
> even remember that the problem existed (the OP says he was an infant).

I am not talking about this particular situation. I'm responding to the
general statement that one need only report what one remembers.

An exception for a specific instance (and I believe, along with you and
others, that the original poster's issue wouldn't be of concern) does not
imply an exception for all instances.

Pete

[Gig 601XL Builder]

"Peter Duniho" > wrote in message
...
> "Gig 601XL Builder" <wr.giacona@coxDOTnet> wrote in message
> news:XzuIe.3518$_t.2031@okepread01...
>> How could someone be required to report something they have no knowledge
>> of?
>
> The same way they are required to be familiar with ALL available
> information pertaining to a flight.
>

The two situations have nothing to do with one another. Example on January 3
1994 at the ripe old age of 32 I had a heart attack. I obviously had a
problem on January 2 but if I had taken a FAA physical on the 2nd there is
no way they could say I withheld a damn thing.

[Gary Drescher]

"Peter Duniho" > wrote in message
...
> "Gig 601XL Builder" <wr.giacona@coxDOTnet> wrote in message
> news:XzuIe.3518$_t.2031@okepread01...
>> How could someone be required to report something they have no knowledge
>> of?
>
> The same way they are required to be familiar with ALL available
> information pertaining to a flight.

But that requirement is established by FAR 91.103, which creates an
affirmative duty to do the necessary research. There is no comparable
requirement to research one's medical history; the only requirement is to
answer some questions truthfully, to the best of one's knowledge at the
time.

--Gary

[Judah]

I'm no lawyer but I think that in a court of law, it would be
considered hearsay. Did the person reminding you of your heart murmur
provide evidence? How do you know the other person's recollection was
indeed accurate? My parents barely remember which kid is which, let
alone who had this procedure or that one. Presumably, since you were an
infant at the time, the person was not REMINDing you of anything -
indeed s/he was relaying a story that could be true or false.

Of course, due diligence might yield additional information, but is it
reasonable to expect you to investigate a heart murmur as an infant (a
VERY common condition - almost all babies are born with a hole in their
heart that seals up within about a week) when the symptoms do not
currently present?

I'm no doctor either. But if it were me, I would mention it to my AME
next time I went in for a medical. Tell him someone told you that you
had a heart murmur as an infant . I suspect he'll pay attention for a
bit, maybe double check, and determine if there is a problem that
requires attention. But he is qualified to make that distinction and
report (or not report) appropriately. And if he reports, it's probably
for your own safety...


wrote in
oups.com:

>
> Okay, here's an odd situation.
>
> 30-something pilot, been flying a few years, have had a couple of
> class III medical examinations; no problems.
>
> On a recent visit home, pilot's family remind him that as infant he
> had a heart murmur. There were checkups for a few years, but no
> restrictions, meds, problems, etc of any sort.
>
> Pilot vaguely remembers some of this on being reminded, but also
knows
> he's never mentioned it to an AME. (As far as he knows, there's no
> murmur today; at least no doctor or AME has mentioned it during an
> exam in the last 20 years.)
>
> Pilot has a one year old medical good for two more years.
>
> 1. does the pilot divulge to FAA said childhood murmur?
> 2. if so, to whom? AME? Oklahoma City?
> 3. does he wait until next exam (couple of years) or do so now?
> 4. If going to divulge, should he go get fancy/expensive tests
*first*
> or let FAA or AME ask for said tests?
>
> Some seriously Googling about murmurs shows the protocol for murmurs
> to be that they are FAA disqualifying until shown to be benign, and
> the FAA has a list of stuff they want a cardiologist to provide to
> make the decision. It's not clear if the AME or OKC needs to do that.
> The list of stuff is long: stress test, ekg, family history, etc.
>
>
> this unnamed flyer is a little freaked out right now. he doesn't want
> to break the law, but doesn't want to give up his one true love,
> flying!
>
> thanks,
> unnamedflyer
>

[Dave S]

Mortimer Schnerd, RN wrote:

> Dave S wrote:
>
>>Congrats Mort... thats my first mispelling someone has kicked back on me
>>in over a year.
>>
>>
>>Thanks for playing.
>
>
>
> We ame to pleeze.
>
>
>
My first response, that I didn't send.. WAS a "hooked on phonics" barb..
I can see we had the same idea.

Dave

[Mortimer Schnerd, RN]

Judah wrote:
> I'm no doctor either. But if it were me, I would mention it to my AME
> next time I went in for a medical. Tell him someone told you that you
> had a heart murmur as an infant . I suspect he'll pay attention for a
> bit, maybe double check, and determine if there is a problem that
> requires attention. But he is qualified to make that distinction and
> report (or not report) appropriately. And if he reports, it's probably
> for your own safety...


I owuldn't be inclined to mention it. If the AME can't hear one now when he
listens, what possible significance can one have been back when you were a kid.
Murmurs generally indicate an incompetent valve, ie, one that leaks. They are
fairly common in kids and people grow out of them all the time. If the doc
can't hear one now, why open a can of worms for the FAA to screw you over with?

Want to listen for one? Lay a stethescope on your chest and listen. Normal
hearts go lub-dub. Murmurs go whoosh-whoosh. If you don't hear it, there isn't
one. For an exagerated murmur sound, find a dialysis patient that has an AV
shunt in his arm. Listen to it (the shunt)... the loudest murmur on the planet.

My AME told me the main thing the FAA looks at is any condition that may cause
incapacitation. Competent valves don't... so I wouldn't feel particularly
guilty over the sin of omission.

Of much more concern to me would be a murmur that appeared where none had
previously been. That would get my attention... the doc's too.



--
Mortimer Schnerd, RN

[Cub Driver]

On Thu, 4 Aug 2005 09:38:54 -0700, "Peter Duniho"
> wrote:

>. You're only required to
>> report what you remember.
>
>That's an interesting take on the regulations. Where'd you get that from?

How could you possibly be required to report something you don't
remember?


-- all the best, Dan Ford

email (put Cubdriver in subject line)

Warbird's Forum: www.warbirdforum.com
Piper Cub Forum: www.pipercubforum.com
the blog: www.danford.net
In Search of Lost Time: www.readingproust.com

[Cub Driver]

On Thu, 04 Aug 2005 19:28:45 GMT, "Steve Foley"
> wrote:

>My guess is that the doctor confused him with his brother.
>The pilot's vague memories are probably regarding his brother.

Plus there is the universal tendency of families' trying to spoil the
fun of a relative they suspect of having too much fun. Probably his
parents made the whole thing up, just to put him in his place.


-- all the best, Dan Ford

email (put Cubdriver in subject line)

Warbird's Forum: www.warbirdforum.com
Piper Cub Forum: www.pipercubforum.com
the blog: www.danford.net
In Search of Lost Time: www.readingproust.com

[Denny]

You guys just slay me... THis TROLL throws out a baited hook and you
are all over it...

denny

[Gary Drescher]

"Denny" > wrote in message
oups.com...
> You guys just slay me... THis TROLL throws out a baited hook and you
> are all over it...

What are you talking about? What makes you think the question isn't sincere?

--Gary

[Ash Wyllie]

Cub Driver opined

>On Thu, 4 Aug 2005 09:38:54 -0700, "Peter Duniho"
> wrote:

>>. You're only required to
>>> report what you remember.
>>
>>That's an interesting take on the regulations. Where'd you get that from?

>How could you possibly be required to report something you don't
>remember?

Dan, we are talking about a governmant bureaucracy here.

On the other hand, how do you prove that someone has forgotten something?

-ash
Cthulhu in 2005!
Why wait for nature?

[[email protected]]

The poster is and was sincere. I did not post under my name, because,
honestly, medical questions are sensitive, as are questions about the
faa and medical certifications. Perhaps I was being paranoid, but I
figure better safe than sorry.

There was nothing 'troll-like' about this question. I did want to see
what people said. Most people backed up what the aeromedical people at
AOPA said. (Actually, it was the other way around, I called AOPA
later.)

-- unnamed

Gary Drescher wrote:
> "Denny" > wrote in message
> oups.com...
> > You guys just slay me... THis TROLL throws out a baited hook and you
> > are all over it...
>
> What are you talking about? What makes you think the question isn't sincere?
>
> --Gary

[George Patterson]

Cub Driver wrote:
>
> Plus there is the universal tendency of families' trying to spoil the
> fun of a relative they suspect of having too much fun. Probably his
> parents made the whole thing up, just to put him in his place.

That possibility also occurred to me. If my mother had known about the way the
FAA medical board works when I was training, I'd probably *still* be waiting on
my student pilot's certificate.

I can guarantee one thing. If you report a condition and then discover that the
old medical records don't exist any more, you're in for a *very* long and
expensive road.

George Patterson
Give a person a fish and you feed him for a day; teach a person to
use the Internet and he won't bother you for weeks.

[George Patterson]

Mortimer Schnerd, RN wrote:
>
> Of much more concern to me would be a murmur that appeared where none had
> previously been. That would get my attention... the doc's too.

And that's *exactly* what this would look like to the FAA medical board if he
checks off that box at his next exam.

George Patterson
Give a person a fish and you feed him for a day; teach a person to
use the Internet and he won't bother you for weeks.

[Peter Duniho]

"Cub Driver" > wrote in message
...
> How could you possibly be required to report something you don't
> remember?

Asked and answered.

[Gig 601XL Builder]

I for one never thought it was a troll. BUT I can see where some might think
so as it was an actual on topic post and there have been so few lately from
new people.




> wrote in message
oups.com...
>
> The poster is and was sincere. I did not post under my name, because,
> honestly, medical questions are sensitive, as are questions about the
> faa and medical certifications. Perhaps I was being paranoid, but I
> figure better safe than sorry.
>
> There was nothing 'troll-like' about this question. I did want to see
> what people said. Most people backed up what the aeromedical people at
> AOPA said. (Actually, it was the other way around, I called AOPA
> later.)
>
> -- unnamed
>
> Gary Drescher wrote:
>> "Denny" > wrote in message
>> oups.com...
>> > You guys just slay me... THis TROLL throws out a baited hook and you
>> > are all over it...
>>
>> What are you talking about? What makes you think the question isn't
>> sincere?
>>
>> --Gary
>

[David Rind]

wrote:
> Okay, here's an odd situation.
>
> 30-something pilot, been flying a few years, have had a couple of class
> III medical examinations; no problems.
>
> On a recent visit home, pilot's family remind him that as infant he had
> a heart murmur. There were checkups for a few years, but no
> restrictions, meds, problems, etc of any sort.

I have absolutely no clue how the FAA views this, but a heart murmur is
not in and of itself a medical condition. It is just a sound heard on
examination, and murmurs are exceedingly common both in children and in
adults. Most murmurs indicate nothing other than some turbulent blood
flow through the heart and do not reflect any sort of medical problem at
all. Occasionally murmurs are an indication of a hole somewhere in the
heart or problems with the heart valves, but I would guess if this were
the case for the OP he would know about it.

--
David Rind

[Ron Rosenfeld]

On 4 Aug 2005 03:01:10 -0700, wrote:

>Pilot has a one year old medical good for two more years.
>
>1. does the pilot divulge to FAA said childhood murmur?
>2. if so, to whom? AME? Oklahoma City?
>3. does he wait until next exam (couple of years) or do so now?
>4. If going to divulge, should he go get fancy/expensive tests *first*
>or let FAA or AME ask for said tests?

I believe the relevant question on the FAA medical exam -- at least what is
posted on the AOPA web site -- is: "HAVE YOU EVER IN YOUR LIFE BEEN
DIAGNOSED WITH, HAD, OR DO YOU PRESENTLY HAVE Heart or vascular trouble?"

Note that the question does not ask if you have ever had a heart murmur.

Having had a transient heart murmur as an infant, with no diagnosis of
"heart trouble" does not require you to answer this question with a YES --
in my opinion as a (retired) cardiologist.


Ron (EPM) (N5843Q, Mooney M20E) (CP, ASEL, ASES, IA)

[Morgans]

"Ron Rosenfeld" > wrote

> I believe the relevant question on the FAA medical exam -- at least what
is
> posted on the AOPA web site -- is: "HAVE YOU EVER IN YOUR LIFE BEEN
> DIAGNOSED WITH, HAD, OR DO YOU PRESENTLY HAVE Heart or vascular trouble?"

Not that I think that the OP should tell on himself, but I would be
interested in how you think that a heart murmur is not a HEART PROBLEM.
--
Jim in NC

[Ron Rosenfeld]

On Fri, 5 Aug 2005 23:45:03 -0400, "Morgans" >
wrote:

>
>"Ron Rosenfeld" > wrote
>
>> I believe the relevant question on the FAA medical exam -- at least what
>is
>> posted on the AOPA web site -- is: "HAVE YOU EVER IN YOUR LIFE BEEN
>> DIAGNOSED WITH, HAD, OR DO YOU PRESENTLY HAVE Heart or vascular trouble?"
>
>Not that I think that the OP should tell on himself, but I would be
>interested in how you think that a heart murmur is not a HEART PROBLEM.

I guess I should ask you the converse: Why do you think that a heart
murmur IS a heart problem?

A heart murmur is merely a particular kind of sound that may be heard when
listening to a heart. It may be perfectly normal (most are) or it may be
suggestive of some underlying heart condition.

It is only a physical finding; it is not a diagnosis of any diseased
condition.

If there were a problem, the problem would not be the murmur; rather the
problem would be some trouble with the heart such as (in lay terms) "leaky
valve", "hole in the heart", "tight valve", etc.

The OP's description of a possible murmur in infancy; no diagnosis of any
heart disease; no recommended followup; no murmur as an adult; clearly
falls into the "normal finding" category.


Ron (EPM) (N5843Q, Mooney M20E) (CP, ASEL, ASES, IA)

[Morgans]

"Ron Rosenfeld" > wrote

> The OP's description of a possible murmur in infancy; no diagnosis of any
> heart disease; no recommended followup; no murmur as an adult; clearly
> falls into the "normal finding" category.

Agreed, about no fining in adulthood.

I still stand about saying a heart murmur, until thoroughly diagnosed, is a
heart problem. If it is an abnormal sound compared to a normal healthy
heart is heard, it would have to be investigated. This does not seem to be
the case, but if it was heard at one time, it should be checked. (which it
was)
--
Jim in NC

[Morgans]

"Morgans" > wrote
>
> Agreed, about no fining in adulthood.

Make that no "finding" in adulthood.
--
Jim in NC

[Ron Rosenfeld]

On Sun, 7 Aug 2005 03:15:49 -0400, "Morgans" >
wrote:

>
>"Ron Rosenfeld" > wrote
>
>> The OP's description of a possible murmur in infancy; no diagnosis of any
>> heart disease; no recommended followup; no murmur as an adult; clearly
>> falls into the "normal finding" category.
>
>Agreed, about no fining in adulthood.
>
>I still stand about saying a heart murmur, until thoroughly diagnosed, is a
>heart problem. If it is an abnormal sound compared to a normal healthy
>heart is heard, it would have to be investigated. This does not seem to be
>the case, but if it was heard at one time, it should be checked. (which it
>was)

Your misconception about "heart murmur" is common. But I agree with part
of your statement.

The key phrase you mention is "If it is an abnormal sound ..." As I
implied previously, a heart murmur is not necessarily an "abnormal sound".

Any more than other physical finding, which is not present in all
individuals, is abnormal.

I don't know what you mean by "thoroughly diagnosed" either.

The sequence should be: A competent MD listens to a heart. He notes a
heart murmur. It sounds like a functional murmur. (That term means that
it has no clinical significance and does not imply any kind of heart
problem). He tells patient -- "You have an innocent murmur". That should
be the end of it.

Obviously, if MD1 cannot make that determination, he should refer the
patient to a specialist -- either an adult or pediatric cardiologist -- for
further evaluation. The specialist might choose to perform further
testing; or might make the diagnosis of functional murmur based on his/her
own history and physical.

In my practice, it was not unusual to see patients who were paralyzed with
fear over an innocent heart murmur because of this misconception that it
was necessarily abnormal; and they would often require thousands of dollars
of testing before they would accept the fact that they had no heart problem
-- and sometimes even that was not effective.

This misconception exists amongst physicians, too. Especially
non-cardiologists. But some, I think, are driven to refer their patients
for further testing due to uncertainty; some due to malpractice lawsuit
fears; some for economic benefits; etc.


Ron (EPM) (N5843Q, Mooney M20E) (CP, ASEL, ASES, IA)

[George Patterson]

Morgans wrote:
>
> I still stand about saying a heart murmur, until thoroughly diagnosed, is a
> heart problem.

And I would say that you are confusing a symptom of a possible problem with a
problem. A murmur is a symptom, not a problem.

George Patterson
Give a person a fish and you feed him for a day; teach a person to
use the Internet and he won't bother you for weeks.

[Morgans]

"George Patterson" > wrote

A murmur is a symptom, not a problem.
###########################

I think this one has been picked (and over picked) to death.

I think it is all is a conspiracy by the Hitler youth.

Is it dead yet? <g>
--
Jim in NC