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Impairment Classification for Congenital Heart Disease (Cont.)
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Class 2-Impairment of the Whole Person, 15—29% The patient has evidence by physical examination or laboratory studies of congenital heart disease, has no symptoms in the performance of ordinary daily activities, and has no symptoms with moderately heavy physical exertion (functional class 2); or The patient requires moderate dietary adjustments or drugs to prevent symptoms or to remain free of signs of congestive heart failure or other consequences of congenital heart disease, such as syncope, chest pain, emboli, or cyanosis; or There are signs or laboratory evidence of cardiac chamber hypertrophy or dilation, or the severity of valvular stenosis or regurgitation is estimated to be moderate; or there is evidence of a small residual left-to-right or right-to-left shunt; or there is evidence of moderate elevation of the pulmonary vascular resistance, which should be less than one- half the systemic vascular resistance; or The patient has recovered from surgery for the treatment of congenital heart disease and meets the above criteria for impairment.
Class 3—Impairment of the Whole Person, 30—54%The patient has evidence by physical examination or laboratory studies of congenital heartdisease and experiences symptoms during the performance of ordinary daily activities(functional class 3); and Diet modification and drugs do not completely control symptoms or prevent signs of congestive heart failure; and There are signs or laboratory evidence of cardiac chamber hypertrophy or dilation; or the severity of valvularstenosis or regurgitation is estimated to be moderate or severe; orthere is evidence of a right-to-left shunt; or there is evidence of a left-to-right shunt with the pulmonary flow being greater than two times the systemic flow; or the pulmonary vascular resistance is elevated to greater than one-half the systemic vascular resistance;orThe patient has recovered from surgery for the treatment of congenital heart disease but continues to have functional class 3 symptoms, or continues to have signs of congestive failure or cyanosis, and there is evidence of cardiomegaly and significant residual valvular stenosis or regurgitation, left-to-right shunt, right-to-left shunt, or elevated pulmonary vascular resistance.
Class 4—Impairment of the Whole Person, 55—95% The patient has signs of congenital heart disease and experiences symptoms of congestive heart failure at less than ordinary daily activities (functional class 4);
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