Healing Hands Wellness Center

DOT Cardiovascular Examination

From The Desk of Dr Robert C Slater BA, MSC, DC, DOT at Healing Hands Wellness Center, DOT NR#: 3723762400

Comprehensive DOT Includes Cardiovascular Assessment: DOT Total Cost: $45.00

DOT Cardiovascular Examination: If certified without risks, then for 2 years

Most common direct causes of CVD are: hypertension, atherosclerosis, which in turn are caused by lifestyle and behavioral factors mentioned in the HTN section

Begins with chest inspection (noting any surgical scars, pacemaker IAD or defibrillator); auscultate: (listening to irregular heart value sounds: thrills, murmurs,extra sounds or enlargement; noting blood pressure and pulse; noting additional red flag signs of cardiovascular dysfunction: peripheral edema, bruits, diaphoresis (excess sweating) or distended neck veins at the sides of the neck.

Myocardial Infarction Certification Criteria

Disqualification: *Resting angina or change in angina pattern within 3 months of examination: *Ischemic changes on resting ECG: *Intolerance to medication for cardiovascular intervention therapy

Monitoring and Testing: *Clearance from a CV specialists who understands the demands and functions of commercial driving: *Biennial ETT (every 2 years): Waiting Period: minimum of 2 months

Certification: Maximum 1 year: Is asymptomatic, tolerates medicine, has satisfactory exercise tolerance test, has a resting ventricular ejection fraction (LVEF) greater than or equal to 40%, and has no electrocardiogram ischemic changes


Cardiovascular related syncope certification criteria:

Syncope (loss of consciousness) is a symptom of other diseases and not a Dx on its own: Causes: medication, cardiac disease or neurologic disease

Disqualify : *experiences syncope as condition of a disease process, regardless of the underlying condition and or treatment: *is at high risk for syncope or near syncope regardless of the underlying condition and or treatment

Maximum Certification : Maximum certification is 1 year: If:

*has been treated for symptomatic disease: *is asymptomatic: *tolerates medicine: *is at low risk for syncope or near syncope: *has clearance from an appropriate specialists (cardiologists or neurologists) who understand the functions and demands of commercial driving


Extraordinary Consideration: Stroke: Condition : Cerebellar or Brainstem:

Waiting period is 1 year: Maximum certification = 1 year: Required Specialists evaluation: yes, needs neurologists release every year, AND must not have any other disqualifying deficits

Stroke: Condition

Cortical or subcortical: Waiting period is 5 year: Maximum certification = 1 year

Required Specialists evaluation : yes, needs neurologists release: AND Must not have any other disqualifying deficits

If abnormal cardiovascular findings are present, additional cardiovascular testing may be requested and referred to the appropriate medical provider.

1-Echocardiogram: [an Left Ventricular Ejection Fraction greater than or equal to 40%], [no pulmonary hypertension].

2-Exercise Tolerance Test: [exercise to a workload greater than 6 METs..metabolic equivalents], [attain a heart rate greater than or equal to 85% of the predicted maximum – unless on beta-blockers], have a rise in systolic BP greater than 20mm Hg without angina], [have no significant ST segment depression]

Please contact us if you would like to arrange a Home or Office visit for your DOT Examination. We perform DOT physicals for drivers living in or passing through St. Paul and Minneapolis, as well as all surrounding suburbs.