VALVULAR HEART DISEASE The severity of valvular heart disease can be reduced, but not fully reversed, by operative procedures on the valves or by replacement of the valve with a prosthetic device. After such a procedure, sufficient time from the date of operation must elapse to allow maximum recovery of the heart, lungs, and other organs before estimating permanent impairment due to valvular disease.In addition, medications may affect the severity of valvular heart disease, especially limitations due to symptoms. Therefore, sufficient time must be allowed for these medications to be introduced and adjusted, and for them to exert their effects, before an estimate of permanent impairment is made.
Impairment Classification for Valvular Heart Disease Class 1—Impairment of the Whole Person, 1—14% The patient has evidence by physical examination or laboratory studies of valvular heart disease but no symptoms in the performance of ordinary daily activities or even upon moderately heavy exertion (functional class 1); and
The patient does not require continuous treatment, although prophylactic antibiotics may be recommended at the time of a surgical procedure to reduce the risk of bacterial endocarditis; and
The patient remains free of signs of congestive heart failure; and there are no signs of ventricular hypertrophy or dilation, and the severity of the stenosis or regurgitation is estimated to be mild; or
In the patient who has recovered from valvular heart surgery, all of the above criteria are met.
Class 2—Impairment of the Whole Person, 15—29% The patient has evidence by physical examination or laboratory studies of valvular heart disease and there are no symptoms in the performance of ordinary daily activities, but symptoms develop on moderately heavy physical exertion (function class 2); or
The patient requires moderate dietary adjustment or drugs to prevent symptoms. The patient has signs or laboratory evidence of cardiac chamber hypertrophy and/or dilation, and the severity of the stenosis or regurgitation is estimated to be moderate, and surgical correction is not feasible or advisable; or
The patient has recovered from valvular heart surgery and meets the above criteria
Class 3- Impairment of the whole person, 30-54%The patient has signs of valvular heart disease and has slight to moderate symptomatic discomfort during the performance of ordinary daily activities (functional class 3); and
Dietary therapy or drugs do not completely control symptoms or prevent congestive heart failure; and
The patient has signs or laboratory evidence of cardiac chamber hypertrophy or dialation, the severity of the stenosis or regurgitation is estimated to be moderate or severe, and surgical correction is not feasable; (incomplete description)
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