Fitness to Drive in Cardiovascular Disease

Overview

Journal Dtsch Arztebl Int

Specialties General Medicine
Public Health

Date 2017 Oct 31

PMID 29082864

Citations 8

Authors

Hermann H Klein

Udo Sechtem

Hans-Joachim Trappe

Affiliations

Soon will be listed here.

Abstract

Background: Medical students are taught little or nothing about the medical considerations related to the driving of motor vehicles. Physicians treating patients with cardiovascular disease need to acquire competence in traffic medicine in order to be able to advise them about their fitness to drive.

Methods: We present the current governmental regulations and recommendations concerning fitness to drive in patients with cardiovascular disease. We also review pertinent publications that were retrieved by a selective search in PubMed with the search terms "cardiovascular disease and traffic accidents" and "cardiovascular disease and traffic deaths" for the decade 2007-2016, as well as further publications collected by us individually.

Results: Cardiovascular disease can make a driver lose control of a vehicle without warning and thereby lead to an accident. The main pathophysiological mechanisms of sudden loss of control are disturbances of brain perfusion (e.g., syncope with or without cardiac arrhythmia, sudden cardiac death due to ventricular fibrillation or asystole, stroke, aneurysm rupture) and marked general weakness (e.g., after major surgery or in cardiac insufficiency).

Conclusion: Patients with cardiovascular disease should be advised by their physicians about their fitness to drive, and the discussion should be documented in writing. Because of the German law on the confidentiality of medical data, only the affected patient should receive this information, with very few exceptions.

Citing Articles

Position paper: ability to drive in cerebrovascular diseases.

Marx P, Hamann G, Busse O, Mokrusch T, Niemann H, Vatter H Neurol Res Pract. 2020; 1:37.

PMID: 33324902 PMC: 7650052. DOI: 10.1186/s42466-019-0043-z.

A Review of Driving Restrictions in Patients at Risk of Syncope and Cardiac Arrhythmias Associated with Sudden Incapacity: Differing Global Approaches to Regulation and Risk.

Margulescu A, Anderson M Arrhythm Electrophysiol Rev. 2019; 8(2):90-98.

PMID: 31114682 PMC: 6528027. DOI: 10.15420/aer.2019.13.2.

The relationship between illnesses and medical drug consumption with the occurrence of traffic accidents among truck and bus drivers in Tehran, Iran.

Khoshakhlagh A, Yazdanirad S, Laal F, Sarsangi V Chin J Traumatol. 2019; 22(3):142-147.

PMID: 31056467 PMC: 6543181. DOI: 10.1016/j.cjtee.2019.01.009.

[Syncope and fitness to drive].

Klein H Herzschrittmacherther Elektrophysiol. 2018; 29(2):214-218.

PMID: 29766266 DOI: 10.1007/s00399-018-0565-z.

In Reply.

Klein H Dtsch Arztebl Int. 2018; 115(11):188-189.

PMID: 29607808 PMC: 5913581. DOI: 10.3238/arztebl.2018.0188c.

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