If the driver has a history of coronary artery disease (CHD, CAD) and has a history of cardiac stents, the driver should bring a letter from the Cardiologist clearing the driver to drive commercially along with their medication list. The driver will also need to provide a recent exercise tolerance test not more than 2 years old. It will be at the discretion of the Medical Examiner if other tests will be accepted or required.

Other cardiovascular contions such as arrythmias, particulary ventricular arrythmias may be disqualifying. Any defibrillators are disqualifying becuase it is unknown when they will fire making the driver unsafe to operate a commercial vehicle.

Pacemakers must be functioning correctly. The driver must not be symtomatic, and have annual examinations with documnented checks. The driver should provide a Cardiac Clearance letter stating ability to drive commercially. Pacemakers are disqualifying unless 1-3 months after placment depending on the type.