A driver with congestive heart failure may be certified if their left ventricular ejection fraction is at least:

When assessing a driver with congestive heart failure, the left ventricular ejection fraction (LVEF) is a critical factor in determining their fitness for duty. The LVEF measures the percentage of blood being pumped out of the left ventricle with each heartbeat, and it helps indicate how well the heart is functioning.

In the context of driver certification, medical guidelines suggest that a minimum LVEF of 40% is necessary for a driver with congestive heart failure to be considered for certification. An ejection fraction below this level typically indicates a significant degree of heart dysfunction, which may impair the driver's ability to safely operate a vehicle due to potential symptoms like fatigue, shortness of breath, or the risk of sudden incapacitation.

Thus, the requirement of having at least a 40% LVEF outlines a balance between safety and acknowledging the medical condition of an individual. This threshold provides a guideline that helps medical examiners determine whether the driver poses a potential risk to themselves or others on the road.

In contrast, LVEF values below this threshold would generally not meet the safety criteria for certification, while values significantly above 40% would indicate a better functional capacity but are not necessary to fulfill the minimum requirement for certification.