Medical aspects of fitness to drive a guide for medical practitioners

3.7
Congenital heart disease
3.8
Aneurysm
Medical standards for individuals applying for or renewing a class 1 or class 6 licence and/or
a D, F, R, T or W endorsement (see appendix 3)
When driving should cease
An individual should not drive for at least six weeks following successful surgery for
congenital heart disease. Specialist assessment should be undertaken before driving
can resume.
When driving may resume or may occur
An individual may be fit to drive six weeks after successful surgery for congenital heart
disease if there are no electrocardiographic changes, symptoms, arrhythmias, cardiac
failure, poorly controlled anticoagulant therapy (see section 3.6), severe hypertension
or other conditions that would render the individual unfit to drive.
Medical standards for individuals applying for or renewing a class 2, 3, 4 or 5 licence and/or
a P, V, I or O endorsement
When driving may resume or may occur
Individuals with asymptomatic minor congenital heart disorders (including mild
pulmonary stenosis, a small atrial or ventricular septal defect, a bicuspid aortic valve
without stenosis, and mild coarctation of the aorta without aortic aneurysm) may
be fit to drive if there are no electrocardiographic changes, symptoms, arrhythmias,
poorly controlled anticoagulant therapy (see section 3.6), severe hypertension or other
conditions that would render the individual unfit to drive. An individual may be fit to
drive three months after successful surgery for congenital heart disease if:
• there are no electrocardiographic changes, symptoms, arrhythmias, poorly
controlled anticoagulant therapy (see section 3.6), severe hypertension or other
conditions that would render the individual unfit to drive, and
• there is no evidence of myocardial ischaemia on adequate stress (exercise or
pharmacological) testing (electrocardiographic, echocardiographic or scintigraphic).
The Agency may impose licence conditions for regular medical assessment,
eg annual cardiologist review. Specialist assessment should be undertaken before
driving can resume.
Medical standards for individuals applying for or renewing a class 1 or class 6 licence and/or
a D, F, R, T or W endorsement (see appendix 3)
When driving should cease
An individual with a thoracic aneurysm of greater than 6.5 cm diameter, or abdominal
aortic aneurysm of greater than 5.5 cm, or another vascular abnormality at risk of
dissection or rupture, is generally considered unfit to drive. Individuals with Marfans
Syndrome should not drive if they have an aneurysm of greater than 4.5 cm.
In exceptional circumstances, the Agency may grant a licence subject to a favourable
specialist report.
When driving may resume or may occur
An individual may be fit to drive six weeks after successful surgery.
Medical standards for individuals applying for or renewing a class 2, 3, 4 or 5 licence and/or
a P, V, I or O endorsement
When driving should cease
An individual with a thoracic aneurysm of greater than 6.5 cm diameter, or abdominal
aortic aneurysm of greater than 5.5 cm, or another vascular abnormality at risk of
dissection or rupture, is normally considered unfit to drive. Individuals with Marfans
Syndrome should not drive if they have an aneurysm of greater than 4.5 cm.
When driving may resume or may occur
The possibility of returning to driving after successful surgery may be reviewed
three months after such surgery, if there are no significant complications. Specialist
assessment should be undertaken before driving resumes.
58 3. Cardiovascular conditions | Medical aspects of fitness to drive | NZTA July 2009
July 2009 NZTA | Medical aspects of fitness to drive | 3. Cardiovascular conditions 59