The Federal Motor Carrier Safety Administration has multiple heart-related medical guidelines that determine the status of a driver’s CDL. The guidelines include the following:

A driver must not have a current clinical diagnosis of myocardial infarction (heart attack), angina pectoris (chest pain), coronary insufficiency (insufficient blood flow through one or more coronary arteries, or the arteries encircling the heart), thrombosis (blood clots) or any other type of cardiovascular disease that may be accompanied by loss of consciousness, breathlessness, collapse or congestive cardiac failure. See our “Heart Terms Defined” article for further explanation of some of these conditions.

The driver can’t have a clinical diagnosis of high blood pressure likely to interfere with his or her ability to operate a commercial motor vehicle safely. Typically this means if the driver’s blood pressure is higher than 140/90 he or she likely will be granted a temporary medical certification of up to one year with periodic check-ups. With a blood pressure greater than 180/110, the driver cannot be qualified until his or her blood pressure is demonstrated to be below 140/90 with treatment well tolerated.

Additionally, FMCSA requires that the driver not have any established medical history or clinical diagnosis of vascular disease that interferes with his or her ability to operate a CMV safely. Vascular disease includes disorders that affect the integrity of blood vessels and arteries away from the heart; the disorders include peripheral artery disease, renal artery disease, Raynaud’s Disease, Buerger’s disease, peripheral venous disease, varicose veins and venous blood clots.

The key to these regulations is the qualifier that they interfere with an individual’s ability to safely operate a CMV. With some exceptions, such as the specific guidelines for blood pressure levels, many of these guidelines are left up to the discretion of the doctor performing the CDL medical exam.