Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Cardiac Stress Test


Related Terms

  • Echo Stress Testing
  • Electrocardiograph Stress Testing
  • Exercise Stress Test
  • Exercise Testing
  • Exercise Tolerance Test
  • Nuclear Stress Testing
  • Pharmacologic Stress Test
  • Stress Testing

Specialists

  • Cardiovascular Internist

Comorbid Conditions

Factors Influencing Duration

Length of disability is usually related to the underlying diagnosis. Unless complications occur, the procedure itself is not associated with disability.

Medical Codes

ICD-9-CM:
89.4 - Cardiac Stress Tests and Pacemaker Checks
89.41 - Cardiac Stress Test Using Treadmill
89.42 - Masters Two-step Stress Test
89.43 - Cardiovascular Stress Test Using Bicycle Ergometer
89.44 - Other Cardiovascular Stress Test; Thallium Stress Test with or without Transesophageal Pacing

Overview

A cardiac stress test evaluates heart function during exertion. During exertion, the heart's demand for oxygen is increased. Testing the heart's reaction to this increased demand provides information necessary for the diagnosis of cardiac disease or abnormalities.

The heart's reaction to the exertion is usually measured by electrocardiography (ECG). ECG is a test that uses 12 sensors placed at specific locations on the individual's body. Through these sensors, the heart's electrical activity is measured. Additional methods of measuring the heart's reaction during a stress test include echocardiography, which uses ultrasound to visualize the heart structures, and myocardial perfusion scanning, an imaging procedure that uses a radioactive compound.

The cardiac stress test is widely used for evaluation in individuals with suspected or proven cardiac disease. Coronary artery disease (CAD) is a major cause of disease and death. The treadmill cardiac stress test has a sensitivity and specificity for CAD of 65% to 80% (Tate 119).

Source: Medical Disability Advisor



Reason for Procedure

A cardiac stress test is performed to screen for coronary artery disease (CAD) in symptomatic individuals, to evaluate chest pain and its cause, to diagnose or rule out coronary artery disease, to identify arrhythmias that develop during exercise, to determine the functioning capacity of the heart after surgery or myocardial infarction, and to evaluate the effectiveness of therapy for cardiac arrhythmias or ischemic disorders.

This test may be used as part of an initial evaluation for CAD instead of coronary angiography, particularly if the suspicion for atherosclerotic heart disease is lower. In an individual thought to be at high-risk for atherosclerosis, this test may be skipped and a coronary angiogram performed as part of the initial evaluation.

Source: Medical Disability Advisor



How Procedure is Performed

The individual undergoing cardiac stress testing abstains from eating, drinking, or smoking 2 to 4 hours before testing. A resting (baseline) ECG is obtained before beginning the test.

Exertion is typically induced by exercise, such as pedaling a stationary bicycle or walking on a treadmill. After an initial warm-up phase on the selected mode of exercise, the workload is gradually increased by small increments. At each exercise level (or after each minute of exercise, depending on the protocol), an ECG is recorded. ECGs are also recorded periodically for at least 6 to 10 minutes after exercise is stopped. If insufficient blood supply to the heart muscle (myocardial ischemia) develops during exercise, characteristic ECG changes will appear. Blood pressure is also checked at frequent intervals, and the individual is asked to report any symptoms. In individuals who cannot perform the exercises, the cardiac effects of exercise may be simulated with certain medications that dilate the blood vessels (adrenergic or coronary vasodilators).

If echocardiography is done in conjunction with the stress test, a baseline echocardiogram is obtained prior to exercise. Another is done immediately after exercise. From these images, motion of the heart wall can be analyzed. If myocardial ischemia develops during exercise, abnormal wall motion will appear in the area of ischemia. If myocardial perfusion scan is performed, a radioactive compound is injected into a vein. The compound circulates throughout the heart and is taken up by the heart muscle (myocardium). The radioactivity is detected by special cameras that produce an image of the heart, revealing areas of oxygen deficiency (ischemia). The scan is obtained immediately after stopping exercise, and a second scan is done several hours later after resting. When an individual is unable to exercise, medications that simulate the cardiac effects of exercise may be given instead.

Source: Medical Disability Advisor



Prognosis

The cardiac stress test is an effective and widely used procedure that provides information about an individual's heart and how it responds to exertion. This information is invaluable in screening for and evaluating heart disease.

Source: Medical Disability Advisor



Complications

The test may need to be stopped if irregular heart action (arrhythmias), a drop in blood pressure below baseline, chest pain (angina), difficulty breathing (dyspnea), dizziness or fainting, uncontrolled hypertension, excessive fatigue, or other significant symptoms occur. The possibility of fatal cardiac arrhythmias or myocardial infarction exists. Testing is terminated when maximum capacity (target heart rate) is reached or the individual asks to stop.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

There are no restrictions or accommodations associated with a cardiac stress test.

Source: Medical Disability Advisor



References

Cited

Tate, C. "Cardiovascular diseases." Practical Guide to the Care of the Medical Patient. 6th ed. St. Louis: Mosby-Year Book, Inc., 2004. 119-121.

Source: Medical Disability Advisor






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