Doctor, am I allowed to drive? A practical case-based guide on fitness to drive in cardiovascular diseases adapted from the Swiss model

1. European Parliament. Directive (EU) 2016/1106 of the Commission of 7 July 2016 amending Directive 2006/126/EC of the European Parliament and of the Council on driving licenses. Available at: http://data.europa.eu/eli/dir/2016/1106/oj. Accessed 10 July 2023. European Parliament . Directive (EU) 2016/1106 of the Commission of 7 July 2016 amending Directive 2006/126/EC of the European Parliament and of the Council on driving licenses . Available at: http://data.europa.eu/eli/dir/2016/1106/oj . Accessed 10 July 2023 . Search in Google Scholar

2. Directive 2006/126/EC of the European Parliament and of the Council of 20 December 2006 on driving licences. Available at: http://data.europa.eu/eli/dir/2006/126/oj. Accessed 10 July 2023. Directive 2006/126/EC of the European Parliament and of the Council of 20 December 2006 on driving licences . Available at: http://data.europa.eu/eli/dir/2006/126/oj . Accessed 10 July 2023 . Search in Google Scholar

3. Assessing fitness to drive for commercial and private vehicle drivers: Medical standards for licensing and clinical management guidelines AUSTROADS National Road Transport Commission (2022 edition). Sydney 2022. Available at: https://austroads.com.au/__data/assets/pdf_file/0037/498691/AP-G56-22_Assessing_Fitness_Drive.pdf. Accessed 10 July 2023. Assessing fitness to drive for commercial and private vehicle drivers: Medical standards for licensing and clinical management guidelines AUSTROADS National Road Transport Commission ( 2022 edition). Sydney 2022 . Available at: https://austroads.com.au/__data/assets/pdf_file/0037/498691/AP-G56-22_Assessing_Fitness_Drive.pdf . Accessed 10 July 2023 . Search in Google Scholar

4. Simpson C, Dorian P, Gupta A, Hamilton R, Hart S, Hoffmaster B, et al.; Canadian Cardiovascular Society Consensus Conference. Assessment of the cardiac patient for fitness to drive: drive subgroup executive summary. Can J Cardiol 2004;20(13):1314–20. Simpson C Dorian P Gupta A Hamilton R Hart S Hoffmaster B .; Canadian Cardiovascular Society Consensus Conference . Assessment of the cardiac patient for fitness to drive: drive subgroup executive summary . Can J Cardiol 2004 ; 20 ( 13 ): 1314 – 20 . Search in Google Scholar

5. Deutsche Gesellschaft für Kardiologie – Herz-und Kreislaufforschung e.V. (2023) Pocket-Leitlinien. Fahreignung bei kardiovaskulären Erkrankungen, Version 2023. Börm Bruckmeier Verlag, Grünwald. Available at: https://leitlinien.dgk.org/files/14_2023_pocket_leitlinien_fahreignung.pdf. Accessed 10 July 2023. Deutsche Gesellschaft für Kardiologie – Herz-und Kreislaufforschung e.V . ( 2023 ) Pocket-Leitlinien . Fahreignung bei kardiovaskulären Erkrankungen, Version 2023 . Börm Bruckmeier Verlag , Grünwald . Available at: https://leitlinien.dgk.org/files/14_2023_pocket_leitlinien_fahreignung.pdf . Accessed 10 July 2023 . Search in Google Scholar

6. Buser M, Christen S, Schär B, Fellay M, Pfäffli M. Fahreignung und kardiovaskuläre Erkrankungen: gemeinsame Richtlinien der Schweizerischen Gesellschaft für Kardiologie und der Schweizerischen Gesellschaft für Rechtsmedizin. Cardiovasc Med 2019;22:w02023. doi:10.4414/cvm.2019.02023. Buser M Christen S Schär B Fellay M Pfäffli M . Fahreignung und kardiovaskuläre Erkrankungen: gemeinsame Richtlinien der Schweizerischen Gesellschaft für Kardiologie und der Schweizerischen Gesellschaft für Rechtsmedizin . Cardiovasc Med 2019 ; 22 : w02023 . doi: 10.4414/cvm.2019.02023 . Open DOISearch in Google Scholar

7. Driver and Vehicle Licensing Agency. Assessing fitness to drive – a guide for medical professionals, Version August 2018. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/736938/assessing-fitness-to-drive-a-guide-for-medical-professionals.pdf. Accessed 10 July 2023. Driver and Vehicle Licensing Agency . Assessing fitness to drive – a guide for medical professionals, Version August 2018 . Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/736938/assessing-fitness-to-drive-a-guide-for-medical-professionals.pdf . Accessed 10 July 2023 . Search in Google Scholar

8. ORDIN Nr. 1530/2017 din 28 decembrie 2017 pentru modificarea Normelor minime privind aptitudinile fizice şi mentale necesare pentru conducerea unui autovehicul, aprobate prin Ordinul ministrului sănătăţii nr. 1.162/2010. Available at: http://sant.ro/informatii-utile/legislatie/legislatie-in-vigoare/2017/Ordin%20nr%201530%20din%2028%20decembrie%202017. pdf. Accessed 11 July 2023. ORDIN Nr . 1530/2017 din 28 decembrie 2017 pentru modificarea Normelor minime privind aptitudinile fizice şi mentale necesare pentru conducerea unui autovehicul, aprobate prin Ordinul ministrului sănătăţii nr. 1.162/2010 . Available at: http://sant.ro/informatii-utile/legislatie/legislatie-in-vigoare/2017/Ordin%20nr%201530%20din%2028%20decembrie%202017.pdf . Accessed 11 July 2023 . Search in Google Scholar

9. Hughes BP, Newstead S, Anund A, Shu CC, Falkmer T. A review of models relevant to road safety. Accid Anal Prev 2015;74:250–70. doi: 10.1016/j.aap.2014.06.003. Hughes BP Newstead S Anund A Shu CC Falkmer T. A review of models relevant to road safety . Accid Anal Prev 2015 ; 74 : 250 – 70 . doi: 10.1016/j.aap.2014.06.003 . Open DOISearch in Google Scholar

10. Chee JN, Simpson C, Sheldon RS, Dorian P, Dow J, Guzman J, Raj SR, Sandhu RK, Thiruganasambandamoorthy V, Green MS, Krahn AD, Plonka S, Rapoport MJ. A systematic review of the risk of motor vehicle collision in patients with syncope. Can J Cardiol 2021;37(1):151–161. doi: 10.1016/j.cjca.2020.02.070. Chee JN Simpson C Sheldon RS Dorian P Dow J Guzman J Raj SR Sandhu RK Thiruganasambandamoorthy V Green MS Krahn AD Plonka S Rapoport MJ . A systematic review of the risk of motor vehicle collision in patients with syncope . Can J Cardiol 2021 ; 37 ( 1 ): 151 – 161 . doi: 10.1016/j.cjca.2020.02.070 . Open DOISearch in Google Scholar

11. Miao Q, Zhang YL, Miao QF, Yang XA, Zhang F, Yu YG, Li DR. Sudden death from ischemic heart disease while driving: cardiac pathology, clinical characteristics, and countermeasures. Med Sci Monit 2021;27:e929212. doi: 10.12659/MSM.929212. Miao Q Zhang YL Miao QF Yang XA Zhang F Yu YG Li DR . Sudden death from ischemic heart disease while driving: cardiac pathology, clinical characteristics, and countermeasures . Med Sci Monit 2021 ; 27 : e929212 . doi: 10.12659/MSM.929212 . Open DOISearch in Google Scholar

12. Marelli AJ, Mackie AS, Ionescu-Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 2007;115(2):163–72. doi: 10.1161/CIRCULATIONAHA.106.627224. Marelli AJ Mackie AS Ionescu-Ittu R Rahme E Pilote L . Congenital heart disease in the general population: changing prevalence and age distribution . Circulation 2007 ; 115 ( 2 ): 163 – 72 . doi: 10.1161/CIRCULATIONAHA.106.627224 . Open DOISearch in Google Scholar

13. Baumgartner H, De Backer J, Babu-Narayan SV, Budts W, Chessa M, Diller GP, et al.; ESC Scientific Document Group. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J 2021;42(6):563–645. doi: 10.1093/eurheartj/ehaa554. Baumgartner H De Backer J Babu-Narayan SV Budts W Chessa M Diller GP .; ESC Scientific Document Group . 2020 ESC Guidelines for the management of adult congenital heart disease . Eur Heart J 2021 ; 42 ( 6 ): 563 – 645 . doi: 10.1093/eurheartj/ehaa554 . Open DOISearch in Google Scholar

14. Silversides CK, Marelli A, Beauchesne L, Dore A, Kiess M, Salehian O, et al. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: executive summary. Can J Cardiol 2010;26(3):143–50. doi: 10.1016/s0828-282x(10)70352-4. Silversides CK Marelli A Beauchesne L Dore A Kiess M Salehian O .Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: executive summary . Can J Cardiol 2010 ; 26 ( 3 ): 143 – 50 . doi: 10.1016/s0828-282x(10)70352-4 . Open DOISearch in Google Scholar

15. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52(23):e143–e263. doi: 10.1016/j.jacc.2008.10.001. Warnes CA Williams RG Bashore TM Child JS Connolly HM Dearani JA . ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) . Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons . J Am Coll Cardiol 2008 ; 52 ( 23 ): e143 – e263 . doi: 10.1016/j.jacc.2008.10.001 . Open DOISearch in Google Scholar

16. Gehi AK, Duong TD, Metz LD, Gomes JA, Mehta D. Risk stratification of individuals with the Brugada electrocardiogram: a meta-analysis. J Cardiovasc Electrophysiol 2006;17(6):577–83. doi: 10.1111/j.1540-8167.2006.00455.x. Gehi AK Duong TD Metz LD Gomes JA Mehta D . Risk stratification of individuals with the Brugada electrocardiogram: a meta-analysis . J Cardiovasc Electrophysiol 2006 ; 17 ( 6 ): 577 – 83 . doi: 10.1111/j.1540-8167.2006.00455.x . Open DOISearch in Google Scholar

17. Kannel WB, Dawber TR, Sorlie P, Wolf PA. Components of blood pressure and risk of atherothrombotic brain infarction: the Framingham study. Stroke 1976;7(4):327–31. doi: 10.1161/01.str.7.4.327. Kannel WB Dawber TR Sorlie P Wolf PA . Components of blood pressure and risk of atherothrombotic brain infarction: the Framingham study . Stroke 1976 ; 7 ( 4 ): 327 – 31 . doi: 10.1161/01.str.7.4.327 . Open DOISearch in Google Scholar

18. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al.; ESC Committee for Practice Guidelines. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(41):2873–926. doi: 10.1093/eurheartj/ehu281. Erbel R Aboyans V Boileau C Bossone E Bartolomeo RD Eggebrecht H .; ESC Committee for Practice Guidelines . 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC) . Eur Heart J . 2014 ; 35 ( 41 ): 2873 – 926 . doi: 10.1093/eurheartj/ehu281 . Open DOISearch in Google Scholar