Congenital heart conditions
What the FAA's documents say about congenital heart conditions, in plain words, with the FAA's own words one press away.
FAA term: Congenital Heart Conditions (Atrial Septal Defect (ASD); Coarctation of the Aorta; Patent Foramen Ovale (PFO); Pulmonary Atresia; Tetralogy of Fallot; Tricuspid Atresia; Ventricular Septal Defect (VSD); and others)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
CONGENITAL HEART CONDITIONS Atrial Septal Defect (ASD); Coarctation of the Aorta; Patent Foramen Ovale (PFO); Pulmonary Atresia; Tetralogy of Fallot; Tricuspid Atresia; Ventricular Septal Defect (VSD); and others All Classes
Short version
The disposition table has three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AA PFO not surgically corrected, uncomplicated and asymptomatic | Examiner issues | Examiner can issue |
| Row BASD simple surgical closure or PFO surgically closed, now asymptomatic | Defers to the FAA | Special Issuance |
| Row CRow C's list, or any other congenital heart/cardiac condition | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Congenital heart conditions
- Row A · Examiner can issue
A patent foramen ovale (PFO) which is not surgically corrected, uncomplicated, and asymptomatic. The table says this may be identified as a finding on an imaging study such as echo. If the examiner can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended, the table says ISSUE, and the examiner discusses the history and any current symptoms in Item 60. If any concerns, the table says go to row B.
A. Patent Foramen Ovale (PFO) which is: • Not surgically corrected, • Uncomplicated, • Asymptomatic. This may be identified as a finding on an imaging study such as echo. If the AME can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended: ISSUE Discuss the history and if any current symptoms in Item 60 If any concerns, go to row B.
- Row B · Special Issuance
An atrial septal defect (ASD) with simple surgical closure, or a patent foramen ovale (PFO) surgically closed, and now asymptomatic. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
B. Atrial Septal Defect (ASD)-- simple surgical closure OR Patent Foramen Ovale (PFO) -- surgically closed And now Asymptomatic Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- Row C · Special Issuance
Row C names atrioventricular septal defect (followed by "(ASD)", as printed), coarctation of the aorta (marked with an asterisk), double-outlet right ventricle, d-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, patent ductus arteriosus (PDA), pulmonary atresia, single ventricle, tetralogy of Fallot, total anomalous pulmonary venous return, tricuspid atresia, truncus arteriosus and ventricular septal defect (VSD), or any other congenital heart/cardiac condition. The table lists what to submit for FAA review, and its note says once these records are reviewed, additional testing or information may be required. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
C. • Atrioventricular Septal Defect (ASD) • Coarctation of the Aorta* • Double-outlet Right Ventricle • d-Transposition of the Great Arteries • Ebstein Anomaly • Hypoplastic Left Heart Syndrome • Interrupted Aortic Arch •Patent Ductus Arteriosus (PDA) • Pulmonary Atresia • Single Ventricle • Tetralogy of Fallot • Total Anomalous Pulmonary Venous Return • Tricuspid Atresia • Truncus Arteriosus • Ventricular Septal Defect (VSD) OR Any other congenital heart/cardiac condition Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60. … Note: Once these records are reviewed, additional testing or information may be required.
The FAA pathways for congenital heart conditions
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: what the examiner determines
A PFO that is not surgically corrected, uncomplicated and asymptomatic.For Row A, your AME determines the findings the table lists. If your AME can determine them, the table says ISSUE.
What Row A is
- A patent foramen ovale (PFO) that is not surgically corrected
- Uncomplicated
- Asymptomatic
- It may be identified as a finding on an imaging study such as echo
If the AME can determine
- No symptoms or current problems that would interfere with flight duties
- No treatment is recommended
At the exam
- Your AME discusses the history and any current symptoms in Item 60
If any concerns
- The table says go to row B
Show the FAA's words: Row A: what the examiner determines
A. Patent Foramen Ovale (PFO) which is: • Not surgically corrected, • Uncomplicated, • Asymptomatic. This may be identified as a finding on an imaging study such as echo.
FAA source: Congenital Heart Conditions. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
If the AME can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended: ISSUE
FAA source: Congenital Heart Conditions. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
ISSUE Discuss the history and if any current symptoms in Item 60
FAA source: Congenital Heart Conditions. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
If any concerns, go to row B.
FAA source: Congenital Heart Conditions. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
Step 2: See your AME
If the examiner can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended, the table says ISSUE, and the examiner discusses the history and any current symptoms in Item 60. If any concerns, the table says go to row B.Exam day- If the examiner can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended, the table says ISSUE, and the examiner discusses the history and any current symptoms in Item 60. If any concerns, the table says go to row B.
Show the FAA's words: See your AME
A. Patent Foramen Ovale (PFO) which is: • Not surgically corrected, • Uncomplicated, • Asymptomatic. This may be identified as a finding on an imaging study such as echo. If the AME can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended: ISSUE Discuss the history and if any current symptoms in Item 60 If any concerns, go to row B.
FAA source: Congenital Heart Conditions. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
If the examiner can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended, the table says ISSUE, and the examiner discusses the history and any current symptoms in Item 60. If any concerns, the table says go to row B.
Row BDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
If the examiner defersRow CDefers to the FAASpecial Issuance
The table lists what to submit for FAA review, and its note says once these records are reviewed, additional testing or information may be required. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
A patent foramen ovale (PFO) which is not surgically corrected, uncomplicated, and asymptomatic. The table says this may be identified as a finding on an imaging study such as echo. If the examiner can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended, the table says ISSUE, and the examiner discusses the history and any current symptoms in Item 60. If any concerns, the table says go to row B.
A. Patent Foramen Ovale (PFO) which is: • Not surgically corrected, • Uncomplicated, • Asymptomatic. This may be identified as a finding on an imaging study such as echo. If the AME can determine the individual has no symptoms or current problems that would interfere with flight duties and no treatment is recommended: ISSUE Discuss the history and if any current symptoms in Item 60 If any concerns, go to row B.
- Row B · Special Issuance
An atrial septal defect (ASD) with simple surgical closure, or a patent foramen ovale (PFO) surgically closed, and now asymptomatic. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
B. Atrial Septal Defect (ASD)-- simple surgical closure OR Patent Foramen Ovale (PFO) -- surgically closed And now Asymptomatic Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- Row C · Special Issuance
Row C names atrioventricular septal defect (followed by "(ASD)", as printed), coarctation of the aorta (marked with an asterisk), double-outlet right ventricle, d-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, patent ductus arteriosus (PDA), pulmonary atresia, single ventricle, tetralogy of Fallot, total anomalous pulmonary venous return, tricuspid atresia, truncus arteriosus and ventricular septal defect (VSD), or any other congenital heart/cardiac condition. The table lists what to submit for FAA review, and its note says once these records are reviewed, additional testing or information may be required. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
C. • Atrioventricular Septal Defect (ASD) • Coarctation of the Aorta* • Double-outlet Right Ventricle • d-Transposition of the Great Arteries • Ebstein Anomaly • Hypoplastic Left Heart Syndrome • Interrupted Aortic Arch •Patent Ductus Arteriosus (PDA) • Pulmonary Atresia • Single Ventricle • Tetralogy of Fallot • Total Anomalous Pulmonary Venous Return • Tricuspid Atresia • Truncus Arteriosus • Ventricular Septal Defect (VSD) OR Any other congenital heart/cardiac condition Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60. … Note: Once these records are reviewed, additional testing or information may be required.
If the examiner defersSpecial Issuance
The table marks Row B, an atrial septal defect (ASD) with simple surgical closure, or a PFO surgically closed, and now asymptomatic, DEFER.
The table marks Row C, the conditions it names or any other congenital heart/cardiac condition, DEFER.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, an atrial septal defect (ASD) with simple surgical closure, or a PFO surgically closed, and now asymptomatic, DEFER.
B. Atrial Septal Defect (ASD)-- simple surgical closure OR Patent Foramen Ovale (PFO) -- surgically closed And now Asymptomatic … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks Row C, the conditions it names or any other congenital heart/cardiac condition, DEFER.
OR Any other congenital heart/cardiac condition … DEFER Submit the information to the FAA for a possible Special Issuance.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Row A sends any concerns to row B
Row A is a PFO that is not surgically corrected, and it says that if there are any concerns, go to row B. Row B's words are an ASD with simple surgical closure, or a PFO surgically closed, and now asymptomatic. The table does not say how a PFO that is not surgically corrected fits Row B's words, and this page shows both as printed.
Show the FAA's words: good to know, 2
• Not surgically corrected, … If any concerns, go to row B. … B. Atrial Septal Defect (ASD)-- simple surgical closure OR Patent Foramen Ovale (PFO) -- surgically closed And now Asymptomatic
The table writes ASD for two conditions
Row B names atrial septal defect (ASD). Row C's list names atrioventricular septal defect and prints "(ASD)" after it too. This page shows both as printed.
Show the FAA's words: good to know, 3
B. Atrial Septal Defect (ASD)-- simple surgical closure … C. • Atrioventricular Septal Defect (ASD)
Coarctation of the aorta also asks for a brain MRA
In Row C, coarctation of the aorta carries an asterisk, and the row's seventh item says coarctation of the aorta must also include a brain MRA performed no more than 90 days prior to the exam.
Show the FAA's words: good to know, 4
• Coarctation of the Aorta* … 7. * Coarctation of the Aorta, must also include a Brain MRA performed no more than 90 days prior to the AME exam.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.