Can You Pass a DOT Medical Exam With a Heart Murmur

Can You Pass a DOT Medical Exam With a Heart Murmur?

A normal heart rhythm, as heard through a stethoscope, has two distinct beats. A whooshing sound can indicate a heart murmur. Blood may be passing through the heart in an atypical fashion. It may be a condition you were born with or a sign of disease. The type of heart murmur and accompanying symptoms and dangers (if any) will determine whether you can pass the DOT CDL medical exam.

Murmur Classification

There are three types of heart murmur:

  1. Systolic- You hear the murmur when the heart contracts.
  2. Diastolic- You hear the murmur when the heart relaxes.
  3. Continuous- You hear the murmur during the heart muscle’s contraction and relaxation.

Using a stethoscope, your physician can determine what type of heart murmur you’re dealing with and the severity of the condition through a grading system:


  1. You can barely hear the murmur even with the stethoscope pressed to the skin over the heart. You have to strain to hear it.
  2. You don’t have to strain to hear the murmur, but it’s faint.
  3. You hear a louder murmur but can’t hear it if the stethoscope isn’t pressed against the skin.
  4. You can hear a moderately loud murmur with the stethoscope, and by laying your hand over the heart, you can feel the murmur under your hand.
  5. You can hear the murmur even if the stethoscope doesn’t have full contact with the skin.
  6. You can hear the murmur with the stethoscope near but not touching the skin.

Leading Heart Murmur Causes

Anemia: You have a low red blood cell count, which can make you drowsy and weak.

Carcinoid syndrome: You have a slow-growing malignant tumor, which can cause stomach pains, diarrhea, unexplained weight loss, and low blood pressure.

Congenital heart defect: You were born with an atypical heart structure. You may go your whole life without symptoms, or it can cause sudden death depending on the type of deformity and severity of symptoms.

Endocarditis: You have a bacterial infection of the heart valves. As with other bacterial infections, you may notice a rash, fever, or chills.

Heart valve disease: Your heart valve(s) aren’t functioning correctly. The circulatory system is compromised, leading to edema (swelling), difficulty breathing, heart palpitations, and pain or pressure in the chest.

Hyperthyroidism: You create too much thyroid hormone. You may also feel unexplained anxiety, lose weight unexpectedly, feel too hot, and have a rapid heartbeat.

Hypertrophic cardiomyopathy: You have a heart disease that makes the heart muscle stiff or hard. It can cause fainting, chest pain, difficulty breathing, fatigue, and irregular heartbeat.

How a Murmur Affects Your DOT Physical

The medical examiner must review everyone on a case-by-case basis. If you’re seeing a cardiologist for a heart murmur, share your history and treatment with your medical examiner. It will help them see if your current treatment protocols control your condition. The examiner must establish:

  • Your specific diagnosis, its onset, and progression
  • Your murmur’s severity grade and current symptoms
  • Your current treatment protocol, if any, and its level of success in managing symptoms
  • Your likelihood of curing the ailment through treatment, such as a valve replacement or antibiotics to deal with a bacterial infection
  • Your likelihood of losing consciousness or control over the vehicle due to a cardiac event

The medical examiner may send you to a specialist if they still need more information before making a decision. Additional tests may be needed to determine if you’re a danger to yourself and others on the road.

Appointment Preparation

If you know your condition before your DOT medical exam, a little prep work will save you unnecessary delays. The more information you have on how well you’re managing your condition, the better. Talk to your primary care doctor and cardiologist. If they feel your condition is controlled and you’re safe behind the wheel, get a letter from them stating so and bring it to your appointment. Make sure it has your doctor’s contact information should your medical examiner have questions. You can also bring your medical file so the examiner can review any associated test results.

Arrive 15 minutes early with a valid government-issued identification to check in and fill out the required paperwork. This helps the office run more efficiently so doctors can see their patients on time.

Try to be well-hydrated and get a good night’s sleep before your appointment, as dehydration and insomnia can mimic some of the symptoms of a heart condition, like dizziness and fatigue.

Safety on the Road

A heart murmur on its own may not be a disqualifying condition, but the medical examiner needs to be certain it won’t interfere with your ability to safely navigate the roads while driving multi-ton vehicles on long-haul trips or in populated areas. Showing proof, you have your condition under control could make all the difference in whether you can get your DOT medical card.