1. (1) With respect to conditions affecting cardiovascular function, the review boards when making recommendations, and the department when taking licensing action, may consider disorders including, but not limited to, the following:

   1. (a) Coronary artery disease, including myocardial infarction.
   2. (b) Congestive heart disease.
   3. (c) Valvular disease or replacement valves.
   4. (d) Congenital heart disease.
   5. (e) Cardiomyopathy.
   6. (f) Pericardial disease.
   7. (g) Myocarditis.
   8. (h) Corpulmonale.
   9. (i) Conduction difficulties.
   10. (j) Arrhythmias.
   11. (k) Aortic or arterial occlusion or aneurysm.
   12. (L) Impairment of peripheral circulation.

2. (2) The department may require a person to provide information on the person’s functional ability including, but not limited to, the following:

   1. (a) Hypertension.
   2. (b) Orthostatic hypotension.
   3. (c) Presence of pain and its frequency, location, duration and intensity.
   4. (d) Syncope or presyncopal sensations.
   5. (e) Procedures which correct a cardiovascular condition and which temporarily impair functional ability, including surgical procedures such as a coronary artery bypass graft.
   6. (f) Pacemaker function.
   7. (g) Implanted defibrillator function.
   8. (h) Results of procedures such as an electrocardiogram, stress test with thallium scan, angiography, multigated acquisition scan, echocardiogram, or electrophysiologic studies.
   9. (i) Cardiac drug use, including rhythm control drugs, antianginal agents, cardiac glycosides, antihypertensive medication and side effects of these medications.
   10. (j) Cardiac transplantation.

3. (3)

   1. (a) Licensing standards. No endorsement or license may be issued to, renewed by, or held by a person who does not meet the applicable medical review standards for conditions affecting cardiovascular function of this subsection.

   2. (b) Medical standards for school bus and passenger endorsements. A person who applies for, renews, or holds a school bus or passenger endorsement shall meet all of the following cardiovascular criteria:

      1. 1. The person shows no evidence of exercise-induced ischemia, arrhythmias or hypotension as evidenced by appropriate cardiac testing which has been prescribed and reviewed by a physician or APNP.
      2. 2. Any valvular disease is asymptomatic with no significant ventricular dysfunction.
      3. 4. There are no syncopal or presyncopal sensations.
      4. 5. There is no symptomatic angina pectoris.
      5. 6. There is no documented ventricular tachycardia, severe bradycardia, or high-grade heart block which is unable to be successfully treated.
      6. 7. Any cardiac incident, such as myocardial infarction, occurred more than 6 months preceding any application or renewal unless a cardiac specialist specifically recommends operation of a commercial vehicle and the person has fully recovered.
      7. 8. There is no evidence of congestive heart failure.
      8. 9. There is no automatic implantable cardioverter defibrillator.

   3. (c) Medical standards for all classes of operators licenses. A person who applies for, renews, or holds any classification of operator’s license shall meet all of the following cardiovascular function criteria:

      1. 1. There are no current symptoms of coronary artery disease, such as unstable angina, dyspnea, or pain at rest, which interfere with safe driving, as assessed by a physician or APNP.
      2. 2. There is no cause of cardiac syncope present, including ventricular tachycardia or fibrillation, which is not successfully controlled.
      3. 3. There is no congestive heart failure that limits functional ability and is assessed by a physician or APNP as interfering with safe driving.
      4. 4. Any cardiac rhythm disturbances are successfully controlled.
      5. 5. There is no automatic implantable cardioverter defibrillator, unless the device is assessed by an electrophysiologist as not interfering with safe driving.
      6. 6. There is no valvular heart disease or malfunction of prosthetic valves that is assessed by a physician or APNP as interfering with safe driving.

History

History: Cr. Register, April, 1991, No. 424, eff. 5-1-91; cr. (1) (L), (3) (b) 7., am. (3) (b) 1., r. (3) (b) 4., 5. 9., renum. (3) (b) 6. to 8. to be (3) (b) 4. to 6. and (3) (b) 10. and 11. to be (3) (b) 8. and 9., Register, June, 1996, No. 486, eff. 7-1-96; CR 04-117: r. (3) (b) 3. Register April 2005 No. 592, eff. 5-1-05; CR 06-099: am. (3) (b) 1. and (c) 1., 3. and 6., Register June 2007 No. 618, eff. 7-1-07.