![]() ![]() If the tests are positive or the person remains symptomatic and requires antianginal medication to control symptoms, the requirements listed for proven angina pectoris apply. In the meantime, the person should be advised to restrict their driving until their licence status is determined, particularly in the case of commercial vehicle drivers. Where chest pains of uncertain origin are reported, every attempt should be made to reach a diagnosis. ![]() Nomograms for assessing functional capacity are shown in Figure 7 and Figure 8. Where a patient is not capable of performing a treadmill test due to a medical condition, for example osteoarthritis of the knee, an equivalent stress test may be used. The Bruce protocol or equivalent is recommended for formal exercise testing. An electrocardiogram (ECG) should be performed if clinically indicated. Those who have had a previous myocardial infarction or similar event are at greater risk of recurrence than the normal population, so cardiac history is an important consideration. Health professionals should consider any symptoms of sufficient severity to be a risk while driving. In people with ischaemic heart disease, the severity rather than the mere presence of ischaemic heart disease should be the primary consideration in assessing fitness to drive. Valvular replacement (including treatment with MitraClips and transcutaneous aortic valve replacement) ICD therapy associated with symptoms of haemodynamic compromise Implantable cardioverter defibrillator (ICD) insertion Percutaneous coronary intervention – for example, for angioplasty Minimum non-driving period (advisory) – commercial vehicle drivers Minimum non-driving period (advisory) – private vehicle drivers Table 5: Suggested non-driving periods after cardiovascular events or procedures The recommendations regarding long-term licence status (including conditional licences) should be considered once the condition has stabilised and driving capacity can be assessed as per the licensing standards outlined in this chapter. These non-driving periods are minimum advisory periods only and are not enforceable by the licensing process. The variation in non-driving periods reflects the varying effects of these conditions and is based on expert opinion. Suggested non- driving periods after cardiovascular events or procedures. The person should be advised not to drive for the appropriate period, as shown in Table 5. ![]() Such situations present an obvious driving risk that cannot be addressed by the licensing process in the short term. A number of cardiovascular incidents and procedures affect short-term driving capacity as well as long-term licensing status – for example, acute myocardial infarction and cardiac surgery. ![]()
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