Medical evaluation for driver qualification for patients with cardiovascular disorders

Primary care physicians commonly care for patients whose disabilities caused by cardiovascular diseases result in difficulty driving an automobile. Patients often seek their physician's advice as to whether they can continue to drive safely.

A MEDLINE literature search was performed from 1966 to 2000, using the query terms "automobile driving" and "automobile driving and cardiac." Selected articles were reviewed, as well as additional articles found through review of the references. In some cases articles were found by searching the Internet using the above key words and new query terms guided by the results of the original search.

The most important factor determining eligibility is whether the patient reports manifestations of cerebral hypoxia. Laboratory procedures are available for patients in whom the decision is difficult. Sometimes a referral to a specialist is needed. Many patients with a known cardiovascular disorder can continue to drive safely. Some conditions require a waiting period before driving can be resumed, while others call for a complete cessation of driving. Several guidelines from the literature are listed that can be helpful to primary care physicians when dealing with questions from their patients on this important topic.