Did one 10 years ago due to ECG(turned out to be drinking too much tea!..so gave up tea..)
It’s a treadmill that jacks itself up to create an incline, no running just good paced walk whilst wired up.
The treadmill has an adjustable slope. There is a servo motor which drives it to the specifed slope. Most decent gyms have it although few can do the 16% + required for Stage 4 plus
I’ve done it in the gym. Stage 4 is bloody hard! A fit person can do it though. Stage 5, no idea, never seen a gym machine which can do it, and you would need to be an athlete. But you are not supposed to jog…
The FAA requirements are again slightly different and, as with much FAA medical stuff, more stringent than Euro ones. You need to also achieve a HR of 220-age. The fitter you are the harder you have to work to achieve that. A fit young person will kill himself, needing Stage 5 or even 6.
Lots can affect ECG. Coffee is one, magnesium supplement usually improves things. Not heard of tea affecting it, though hibiscus tea reduces BP (see the BP thread).
My exercise ECG is and will be carried out (the next is in 3 weeks) on a bike about 10 minutes with increasing difficulty every 2 minutes. It and the report will be carried out by my cardiologist who decides when I need one. In my case every 2 or 3 years.
The state pays the cost.
However, the AME decided that amongst other tests I need an exercise ECG annually. It would be done with the same cardiologist and costs about €80.
My cardiologist objects that she is being over ridden by an AME who is not a cardiologist and a DGAC medical council who meet every 3 months and seem to require tests with no evidence that those tests are going to increase safety.
I prefer to trust my cardiologists and my GP with my health and do not see why AMEs can go against their opinions.
Under ICAO if I remember correctly, and carried forward into French law if it isn’t in EASA there is a procedure forbid one is hospitalised or X number of days incapacitated etc. In fact the AME seems to have a thick book on what is required.
Sadly, unlike FAA , here you must take a completed form to the AME these days.
Ridiculous that you have to provide one every year even when nothing has changed.
I think I posted a copy on another thread some time ago. Some of the questions revolve around whether or not you have had certain medical procedures over the past year. You could of course lie as you are on you honour. I’m sure some do. But I am not comfortable doing so.
Tea has a lot of caffeine I think, redbush is now my regular cuppa!
Cool topic 
Looks to me like excercise testing as defined in Part-MED and the AMC is a can of worms indeed. The text says it should only performed “when required as part of cardiovascular assessment..” which should mean if you have no history of cardiovascular disease and no complaints you should never have to do one, but that’s obviously not what is happening all over the place. It also says the test should be “symptom limited and completed to a minimum of stage IV Bruce or equivalent” – but that is weird. The test is normally stopped when you reach 85% of 220-age (the statistical guess for reaching anaerobic threshold). So when you reach that number before stage IV, the test is conventionally stopped (because it has reached its significant endpoint) – but you may not yet have been symptom limited nor did you reach stage IV. So did you pass the test or fail?
according to a CAA insider and a former AME I spoke to – it was determined 3.5% of them would have a heart attack on the treadmill.
That is total nonsense. An educated guess would be zero.
You need to also achieve a HR of 220-age. The fitter you are the harder you have to work to achieve that. A fit young person will kill himself, needing Stage 5 or even 6.
See above. You need to reach 85% of that. Agree that a fit person aiming for 220 would be blue in the face well before getting to 220 :-)
PeteD wrote:
Tea has a lot of caffeine I think, redbush is now my regular cuppa!
Some teas have lots of caffeine indeed but not all. All caffeine intake can cause irregular heart rhythms and I suppose questions during medical exam. Effects should not last very long.
if you have no history of cardiovascular disease and no complaints you should never have to do one, but that’s obviously not what is happening all over the place
AIUI, any dodgy exercise ECG triggers one of
I suppose you could argue that a dodgy non-exercise ECG can be sorted with a cardiologist report.
You need to reach 85% of that.
Not in aviation medicine tests. They want to see 100% of Stage 3, and the FAA wants to see 220-age in addition. Both are supposed to be symptom limited but the only practical way to do that (unless the subject actually collapses) is to fake it when the CAA-required point is reached.
So when you reach that number before stage IV, the test is conventionally stopped
It isn’t stopped…
The FAA, IIRC, allows a bit less than end of Stage 3 or a bit less than 220-age if you are really unfit etc but meet certain other requirements. But there are bigger issues with FAA in Europe e.g. this topic implies Special Issuance but nearly all FAA AMEs refuse to do Special Issuance because it is too much hassle.
a fit person aiming for 220
Impossible because that implies age=0 But say a 30 year old would need to reach 190. How?? More to the point, a 50 year old needs to reach 170 which is likely to be very hard.
On the wider topic, the majority of GA pilots who lose their medical lose it due to cardiology, and most of them give up flying in the weird belief that no more tests → the heart is fine. This is especially daft given that of all the essential organs the heart is the most fixable one (although it will always cost 4 to 5 digits to fix it) and fixing it will improve your quality of life immensely. Much of the rest of medicine has hardly changed in 50-100 years. Well, in the UK they can go on the PMD…
Even non dodgy ECG sees the DGAC demand a nuclear perfusion scan every 3 years whereas a cardiologist might do one 8 to 10 years after an intervention to see whether or not everything has healed as I should. If it has they may never want another unless something else shows up. Cardiologists do not recommend regular nuclear perfusion tests, called Scintographies here,
The bike test here gradually takes you up to 200 to 220 watts if you are reasonably fit. It depends more on how the legs are holding up. They then measure your recovery time whilst monitoring.the ECG and other electrical pulses etc on the computer. The ultrasound scans are not s problem I have a chest and lower body ultrasound scan every year and an ultrasound scan on the carotid artery every 2 years with full reports from cardiologists. But at my last visit the AME decided he wanted further scans every year. That’s when I decided enough was enough.
Even non dodgy ECG sees the DGAC demand a nuclear perfusion scan every 3 years
Incredible given the cancer risk from the radioactive thallium… the blind arrogance!! And what for? Flying a plane???
More to the point, a 50 year old needs to reach 170 which is likely to be very hard.
The first EKG in my lifetime, done as a routine test in middle age, indicated a possible issue. I subsequently got a Bruce Protocol treadmill test done, BTW reached HR well over 170 (equivalent to 10% over 220-Age) at 13.4 MET and was regardless judged ‘good to go’ by the cardiologist.
I took this episode as a hint and switched to FAA Basic Med where I’ll stay for a while or longer, at least until the smoke clears for a number of years. EKGs are not part of FAA Private Pilot medicals and I see no reason to talk to an AME about either of the two I’ve had.
It isn’t stopped…
But it is … at least in EASA land which is what I was referring to with the strange formulation in the regulations. Many cardiologists use a bike instead of a treadmill because it’s easier for the general non-pilot that needs a test (falling risk etc) which makes the whole Bruce stage thing even more theoretical – there’s no easy way to define an equivalent on the bike. Exercise tests for medicals get stopped well before 100% of max HR all day long and do not get rejected – at least not in the regions I’m familiar with. Maybe FAA guidance is different. Weird though – all you get by continuing the test besides a blue face are sore muscles.
This is especially daft given that of all the essential organs the heart is the most fixable one (although it will always cost 4 to 5 digits to fix it) and fixing it will improve your quality of life immensely. Much of the rest of medicine has hardly changed in 50-100 years
I think cardio is really cool too but the last sentence is kind of harsh 
Incredible given the cancer risk from the radioactive thallium… the blind arrogance!! And what for? Flying a plane???
Wow-that’s insane indeed
