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The health rules for black cab drivers are being ever more strictly applied. In this article I am going to restrict myself to writing about my own speciality cardiology.

I am a senior cardiologist looking after all aspects of adult heart disease. I work in North London so I have many London cabbies as patients. They have encouraged me to develop a range of services specially aimed at the taxi trade.

Although taxi drivers drive with a Class 1 driving licence they have to achieve the level of fitness of HGV and PSV drivers who have Class 2 licences.

The rules apply to all professional drivers. They are the same in all parts of the country.

In London TfL enforse the requirements: in other areas it is the local licencing authority.

The commonest issues facing drivers are a history of a

  • heart attack (myocardial infarction; acute coronary syndrome)
  • angioplasty / stent insertion
  • and / or coronary artery bypass grafting (CABG)

In order to drive the requirements are 

  • freedom from angina for at least 6 weeks
  • at least 6 weeks after an angioplasty / stent procedure
  • at least 3 months after coronary artery bypass grafting (CABG)

In addition you have to be able to successfully complete 9 minutes walking on a treadmill using the Bruce protocol.

Further if you have had a coronary artery bypass graft operation (CABG) or angioplasty it is necessary to have an assessment of 

your heart's pumping function. This is most commonly done by means of an echocardiogram (an ultrasound scan).

This measures LVEF (Left Ventricular Ejection Fraction) - To drive this figure needs to be at least 40%.

For various reasons some drivers are unable to walk sucessfully on a treadmill.

In these cases there is an alternative - stress echocardiography. This test is not dependent on the ability to walk on a treadmill.

In my experience most but not all drivers who fail the treadmill test are succesful in passing stress echocardiography.

If you feel that you may not be able to do 9 minuites on the treadmill then it is often best to have a stress echocardiogram.

We are happy to discuss this on an individual basis before testing.

There are other heart problems that require specific tests to allow professional basis. We are happy to discuss your needs.

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