What are the requirements for Department of Transportation (DOT) certification after a myocardial infarction (MI) and coronary artery bypass grafting (CABG)?

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Last updated: May 6, 2025View editorial policy

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From the Research

For Department of Transportation (DOT) certification after a myocardial infarction (MI) and coronary artery bypass grafting (CABG), commercial drivers must wait at least 2 months after an uncomplicated MI and at least 3 months after CABG surgery before being considered for certification. This waiting period is crucial for ensuring the driver's safety and the safety of others on the road, as commercial driving can be physically demanding and stressful, potentially exacerbating cardiac conditions 1. The certification process involves a thorough evaluation of the driver's cardiac health, including their ejection fraction, exercise tolerance, and medication regimen.

Key considerations for DOT certification include:

  • The driver must be asymptomatic and have completed cardiac rehabilitation if prescribed
  • They must demonstrate a stable cardiac condition with an ejection fraction of at least 40%
  • They must pass a satisfactory exercise tolerance test and have no significant arrhythmias
  • They must be on a stable medication regimen, which may include antiplatelet agents, beta-blockers, ACE inhibitors, and statins 2, 3.

Annual recertification is typically required, with documentation of ongoing cardiac stability, to ensure that the driver remains fit to operate a commercial vehicle safely 4, 5. By prioritizing the driver's cardiac health and stability, the DOT certification process helps minimize the risk of cardiac events while driving, thereby protecting public safety.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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