European C lass 3 certification - M itral valve prolapse and regurgitation

M id-systolic click or m itral valve m urm ur If no cardiac or other sym ptom s (note 2):
C ontrolling m ay need to be tem porarily suspended (note 1)
N O TE S : 1) M ay require controlling to be tem porarily suspended whilst under investigation. 2) Includes any cardiac sym ptom s, atrial fibrillation or other arrhythm ias and any history of em bolic events. 3) B y a cardiologist acceptable to the A erom edical S ection (A M S ). Trans oesophageal echocardiography m ay be required. O ther investigations likely to include exercise and 24 hour E CG s. Certification criteria based on echocardiographic and other findings: M inor regurgitation or M itral valve prolapse only Fit E uropean Class 3 Requires evidence of no thickened leaflets or flail chordae and left atrial internal diam eter less than or equal to 4.0 cm M oderate regurgitation Fit E uropean Class 3 S evere regurgitation Unfit E uropean Class 3 The following m ay indicate severe regurgitation: LV internal diam eter (diastole) > 6.0 cm LV internal diam eter (systole) > 4.1 cm Left atrial internal diam eter > 4.5 cm Doppler indices such as width of jet, backwards extension and whether there is flow reversal in the pulm onary veins m ay be helpful in assessing severity of regurgitation. 4) The cardiology report will be reviewed by the A M S . It m ay be necessary to see the investigations in which case the actual tracings/film s/videos will be requested. In difficult cases a secondary review panel of cardiologists will be convened. 5) Follow up at the discretion of the A M S - periodic echocardiography will be required.

C ardiology review (note 3) to include: E chocardiography O ther investigations as necessary

R esults acceptable to the AM S (note 4)

Fit European C lass 3 (note 3) Follow up (note 5)

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