Approximate locations of CAA approved
Cardiologists in the UK
You will generally only have been referred to Dr McLeod if some potentially cardiovascular
(affecting heart and/or blood vessels) problem has been detected at a medical performed
by your AME (Authorised Medical Examiner) or on a routine electrocardiogram (ECG).
There are a number of Cardiologists who have special expertise or experience in
assessing the cardiovascular fitness of pilots to fly. These are found in the approved
list available on the CAA website
(Go to: Safety Regulation/Medical/Other information).
My personal philosophy as a CAA cardiologist is the same as that of the CAA medical
division of the Safety Regulation Group. Our aim is to return pilots safely to the
air if at all possible. Many abnormalities picked up on physical examination or
on the regular ECG recordings need further evaluation - but may reflect little risk
of incapacitation in the air. This is particularly true for professional pilots,
the majority of whom are involved in twin crew or multi-crew operations. Even in
the case of some significant heart problems, the risk of incapacitation in flight
remains sufficiently low for pilots to continue to fly with an "OML" (Operational
Multicrew Limitation), which is not disclosed to third parties such as employers.
On the other hand, most aviators will accept that they are in a privileged position
in terms of the regular checks which they undergo, and if any potential cardiac
problems are flagged up in their medicals, then expeditious investigation can often
prevent their progression to serious manifestations of heart disease. In this situation,
I take the view that the pilot's personal health comes first, and try to minimise
or forestall any progression of cardiac problems.
Investigations undertaken in cardiology are often not onerous and are generally
termed 'non-invasive'. These comprise:
1. Physical examination and ECG (electrocardiogram)
2. Ultrasound scanning of the heart (echocardiography)
3. Exercise ECG (sometimes called a Stress ECG)
4. Prolonged monitoring of the heart rhythm, with a small attached electronic device
(typically a 24 hour ECG), usually called in the USA a "Holter", after
the inventor, Norman Holter
5. If these are not sufficient to diagnose a heart problem, or do not sufficiently
predict the risk of a particular problem, then more sophisticated forms of testing
may be necessary.