Last updated: 31 October 2026
Book your HGV / D4 medical with Dr Steve Walton, Sheffield S12: £80, 30-minute GP examination
The headline rules for lorry and bus drivers
| Event | Tell DVLA? | Earliest relicensing (Group 2) |
|---|---|---|
| Heart attack / acute coronary syndrome (any treatment) | Yes | At least 6 weeks, plus tests below |
| Planned (elective) stent / angioplasty | Yes | At least 6 weeks, plus tests below |
| Coronary bypass surgery (CABG) | Yes | 3 months, plus tests below |
| Angina | Yes | No angina for at least 6 weeks, plus tests |
| Pacemaker fitted | Yes | 6 weeks (box change: no need to notify) |
Source: DVLA Assessing fitness to drive, chapter 2, and GOV.UK: heart attacks, angioplasty and driving. Lorry and bus drivers notify DVLA using form VOCH1.
The three conditions for getting your licence back
After a heart attack, stent or bypass, DVLA will relicense a Group 2 driver only if:
- The minimum time has passed: 6 weeks after a heart attack or stent, 3 months after bypass surgery.
- Your heart pumps well enough. The left ventricular ejection fraction (LVEF) must be at least 40%. DVLA bars Group 2 licensing whenever LVEF is below 40%, whatever the cause.
- You pass the functional test and there is no other disqualifying condition.
The exercise test (Bruce protocol)
The standard test is a treadmill exercise ECG using the Bruce protocol. To pass, you must be able to safely complete 3 stages (9 minutes), or 10 minutes on a bike to 200 W, without:
- angina
- fainting
- a fall in systolic blood pressure of 20 mmHg or more
- an arrhythmia needing intervention or stopping the test
- ECG changes that a cardiologist says show ischaemia (usually 2 mm or more of ST depression or elevation)
You don't need to stop heart medicines such as beta blockers or nitrates before the test. If you can't use a treadmill, a stress scan (myocardial perfusion, stress echo or stress MRI) can be used instead. DVLA usually arranges the tests.
This is why fitness matters. Cardiac rehab and regular walking make the 9-minute target realistic for most people. Section 3a of the D4 even asks whether any other problem (arthritis, COPD, mobility) would stop you doing 9 minutes of the Bruce test.
After you're back: shorter licences and regular tests
A Group 2 licence issued after a heart condition will usually be short-term, for up to 3 years. With established coronary disease, DVLA requires an exercise or other functional test at least every 3 years.
Other heart conditions with Group 2 rules
- Arrhythmia that has caused or could cause incapacity: licence refused until the cause is treated, no incapacitating arrhythmia for at least 3 months and LVEF at least 40%.
- Implanted defibrillator (ICD): a Group 2 licence is permanently revoked, even if the ICD is recommended but not fitted.
- Heart valve surgery: off Group 2 driving for 3 months.
- High blood pressure: see our blood pressure guide.
A typical route back to lorry driving
- Stop driving lorries and buses straight away and tell DVLA using form VOCH1.
- Complete your hospital treatment and, if offered, cardiac rehabilitation. It builds the fitness you need for the exercise test.
- Make sure you have an echocardiogram result showing your ejection fraction. DVLA needs it to be at least 40%.
- After the minimum period (6 weeks, or 3 months after bypass), DVLA makes medical enquiries and may arrange an exercise test or stress scan.
- If the standards are met, a Group 2 licence is usually reissued for a shorter period, with regular functional tests.
Keep copies of all your cardiology letters and test results. Delays are common when DVLA has to chase information.
Your car licence in the meantime
The car rules are less strict. After a heart attack treated with a successful stent you may be able to drive a car after 1 week if certain conditions are met. Otherwise it's 4 weeks. See driving a car after a heart attack, stent or heart surgery.
Your D4 after heart treatment
Section 3 of the D4 covers coronary disease, arrhythmia, devices, valve disease, blood pressure and investigations: exercise ECGs, echocardiograms (and whether LVEF is 40% or more), angiograms and stress scans. Bring your cardiology letters with dates. They make the form accurate and avoid DVLA writing back for details.
As a GP I see the other side of this too. Cardiac rehab, stopping smoking and keeping on top of blood pressure, cholesterol and weight are what keep drivers working long-term.
Book your HGV / D4 medical with Dr Steve Walton, Sheffield S12: £80, 30-minute GP examination
Frequently asked questions
How long after a heart attack can I drive an HGV?
At least 6 weeks, and only after you've told DVLA and met the requirements: left ventricular ejection fraction of at least 40%, a satisfactory exercise or functional test, and no other disqualifying condition.
Can I drive a lorry after a stent?
Yes, potentially. After a planned stent you must notify DVLA and can be relicensed after at least 6 weeks if your LVEF is 40% or more and you pass the exercise or functional test.
What is the DVLA exercise test for HGV drivers?
Usually a treadmill Bruce protocol test. You must safely complete 9 minutes (3 stages) without angina, fainting, a significant blood pressure drop, a serious arrhythmia or ischaemic ECG changes.
Can I drive an HGV after heart bypass surgery?
Licensing can be considered 3 months after CABG if LVEF is at least 40%, the functional test is passed at least 3 months after the operation, and there's no other disqualifying condition.
Can I drive an HGV with an ICD?
No. DVLA permanently revokes a Group 2 licence when an implantable defibrillator is fitted or recommended for ventricular arrhythmia.
Sources (GOV.UK / DVLA)
- Heart attacks, angioplasty and driving (GOV.UK)
- Assessing fitness to drive, chapter 2 and Appendix C (GOV.UK)
Medical standards checked against DVLA's Assessing fitness to drive (November 2025 edition) and GOV.UK guidance, October 2026. Always check GOV.UK for the latest rules.