Cardiovascular Disability Updating the Social Security Listings (2010) / Chapter Skim
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10 Congenital Heart Disease
10 Congenital Heart Disease
Pages 165-182
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From page 165... ...
The abnormal structure of the cardiac chambers, valves, or great vessels in patients with congenital heart disease alters the normal pattern of blood flow. Additionally, individuals with congenital heart disease may develop cardiac complications such as arrhythmias, heart failure, and valve insufficiency, even after surgical correction of the structural abnormalities.
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From page 166... ...
In 2000, 1 million adults in the United States were living with congenital heart disease. An estimated half of them had relatively simple residual disease, one quarter had moderately complex residual disease, and one quarter had severe residual disease (Warnes et al., 2001)
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From page 167... ...
Drug treatments for the complications of congenital heart disease have also advanced, including the development of medications for pulmonary hypertension (Eisenmenger syndrome) and better drug treatments for heart failure and arrhythmias.
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From page 168... ...
Other conditions that may affect overall functional status among congenital heart patients include developmental abnormalities, mental retardation, growth retardation, somatic abnormalities (auditory, dental,
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From page 169... ...
Following cardiac surgery, children may have variable degrees of disability. At school age, 11 to 17 percent of children who have had an operation for their congenital heart disease have significant limitations in adaptive behavior, socialization, communication skills, and daily living skills (Majnemer et al., 2008)
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From page 170... ...
Reevaluation of patients with congenital heart disease at this age can establish their longer-term capacities and facilitate educational and vocational planning. Functional limitations may develop at any age, however, due to the development of arrhythmia, heart failure, endocarditis, or pulmonary hypertension, among other problems.
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From page 171... ...
FIGURE 10-1 Documentation of congenital heart defect likely to require surgery, diagnosis of significant heart disease in infancy or childhood. Figure 10-1 -- LANDSCAPE BLACK WHITE.eps Group A : Birth ( From 6 Months After Hear t Surgery)
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From page 172... ...
Learning disabilities, cognitive impair ment, and associated noncardiac congenital anomalies are frequent comorbidities for individuals with congenital heart disease. Disability evaluators should be trained to understand the effects of these comor bidities to better evaluate if a combination of impairments, no one of which meets a listing, equals a listing.
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From page 173... ...
RECOMMENDATION 10-3. Infants with a medically confirmed diag nosis of cardiac malformation requiring open-heart surgery should be considered disabled until 6 months after definitive corrective surgery.
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From page 174... ...
4 4 CaRdIoVaSCUlaR dISabIlIty BOX 10-1 Current Congenital Heart Disease Listing for Children 104.06 Congenital heart disease, documented by appropriate medically ac ceptable imaging (see 104.00A3d) or cardiac catheterization, with one of the following: A. Cyanotic heart disease, with persistent, chronic hypoxemia as manifested by: 1. ematocrit of 55 percent or greater on two evaluations 3 months or more apart H within a consecutive 12-month period (see 104.00A3e)
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From page 175... ...
SOURCE: SSA, 2008a. onward for whom surgery is not indicated, with congenital heart disease documented by appropriate medically acceptable imaging or cardiac catheterization, with one of the following criteria should be considered disabled: A
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From page 176... ...
Symptomatic acyanotic heart disease interfering seriously with the ability to independently initiate, sustain, or complete activities; OR D Chronic heart failure manifested by: Persistent tachycardia at rest (see Table I1)
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From page 177... ...
Secondary pulmonary vascular obstructive disease with pulmo nary arterial systolic pressure elevated to at least 70 percent of the systemic arterial systolic pressure determined by echocar diography or cardiac catheterization; OR D Single ventricle, including hypoplastic left heart syndrome, double inlet left ventricle, and Fontan operation for single ventricle; OR E
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From page 178... ...
Single ventricle including hypoplastic left heart syndrome, double inlet left ventricle, and Fontan operation for single ventricle; OR E Diagnosis of congenital heart disease and chronic heart failure manifested by: 1.
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From page 179... ...
1996. Pathologic lung function in children and adolescents with congenital heart defects.
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From page 180... ...
2008. Developmental and functional outcomes at school entry in children with congenital heart defects.
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From page 181... ...
H Blackstone, and the Congenital Heart Surgeon's Society.
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