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.

Premature Beats


Related Terms

  • APCS
  • Arrhythmia
  • Atrial Premature Complexes
  • Dysrhythmia
  • PVC
  • Ventricular Extrasystole
  • Ventricular Premature Complexes

Differential Diagnosis

Specialists

  • Cardiologist, Cardiovascular Physician

Comorbid Conditions

  • Anxiety
  • Stress

Factors Influencing Duration

Complications from underlying disease states could influence the length of disability.

Medical Codes

ICD-9-CM:
427.0 - Paroxysmal Supraventricular Tachycardia
427.60 - Cardiac Dysrhythmias; Premature Beats, Unspecified; Ectopic Beats; Extrasystoles; Extrasystolic Arrhythmia; Premature Contractions or Systoles NOS
427.61 - Supraventricular Premature Beats; Atrial Premature Beats, Contractions, or Systoles
427.69 - Cardiac Dysrhythmias; Premature Beats, Other; Ventricular Premature Beats, Contractions, or Systoles

Overview

Premature beats are a type of disturbance in the normal heartbeat that results from altered electrical impulse patterns in the heart (arrhythmia). The arrhythmia in premature beats manifests as an early beat that originates in either the atria or ventricles.

Premature ventricular contractions (PVCs) are the most common type of premature beat. They can occur in healthy or diseased individuals. Disorders commonly associated with PVCs are ischemic, hypertensive, valvular, and congenital heart disease; cardiomyopathy; myocarditis; low potassium (hypokalemia); acidity of the blood (acidosis); coronary artery disease (CAD); and hypermetabolic states. PVCs can be a side effect of anti-arrhythmic drugs; sympathomimetic drugs (notably cold and sinus medications); cardiac catheterization; exercise; anxiety or stress; and excessive caffeine, tobacco, and alcohol.

Premature atrial contractions (PACs) can occur in individuals with normal or diseased hearts. They may be associated with stress, fatigue, alcohol, smoking, CAD, heart failure, pulmonary congestion, and pulmonary hypertension. They can also result from the same drugs/substances that cause PVCs. PACs are linked with paroxysmal supraventricular tachycardia and atrial fibrillation and may accompany heart attack (myocardial infarction) or congestive heart failure.

Premature beats occur occasionally in otherwise healthy individuals and usually are of minimal or no consequence.

Incidence and Prevalence: Holter monitoring of healthy, middle-aged men found PVCs in more than 60% (Stahmer). Holter monitors on well-conditioned runners have demonstrated frequent high-grade atrial and ventricular arrhythmias, suggesting that such variations in heart rhythm are a normal phenomenon (Pantano).

Source: Medical Disability Advisor



Causation and Known Risk Factors

The prevalence of premature beats increases with age (Stahmer).

Source: Medical Disability Advisor



Diagnosis

History: Individuals who have arrhythmias may have no other symptoms. PVCs can cause a feeling of fullness and discomfort in the neck or chest that has been described as a "thumping." Fatigue, weakness, shortness of breath (dyspnea), and chest discomfort occur with frequent PVCs. Symptoms of PVCs are recognized during quiet periods and at rest and disappear with exertion. Individuals may describe the symptoms as "fluttering" and a missed beat.

Physical exam: Distinctive physical signs of PACs include wave patterns in the neck veins and an unusual pause and sound when listening to the heart with a stethoscope. PVCs also produce unusual wave and rhythm patterns.

Tests: An electrocardiogram (ECG) will confirm the diagnosis if the individual actually experiences either of these arrhythmias while being tested. Otherwise, there are no other tests for this disorder.

Source: Medical Disability Advisor



Treatment

There is often no treatment for atrial and ventricular premature beats, other than requiring that the individual avoid alcohol, caffeine, nicotine, and / or prescription drugs that may trigger the onset of arrhythmias. Drugs that slightly accelerate the heart rate usually alleviate the arrhythmia if it occurs persistently or frequently. Anti-arrhythmic drugs that suppress PVCs are usually not given unless the individual has experienced an acute myocardial infarction.

Source: Medical Disability Advisor



Prognosis

Most individuals with premature beats live a normal life unless there is significant underlying heart disease.

Source: Medical Disability Advisor



Complications

Underlying heart disease and the symptoms that are related to this condition may complicate arrhythmias.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions and accommodations are not necessary for this condition.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Did individual describe symptoms such as fluttering in the chest that are characteristic of a premature beat?
  • Does individual have any underlying heart or lung conditions or electrolyte disturbances that may be associated with a premature beat?
  • Was an irregular pulse or irregular heart sounds noted on the physical exam?
  • Were additional studies, such as serum electrolytes, oxygen saturation tests, cardiac isoenzymes, cardiac catheterization, treadmill test, and cardiac ultrasound, performed to determine an underlying cause?
  • Was individual referred to an appropriate specialist (i.e., cardiologist, internist, or pulmonologist)?
  • Have other dysrhythmias such as sinus arrhythmia, sinoatrial block, atrial fibrillation, or atrioventricular blocks been considered in the differential diagnosis?

Regarding treatment:

  • Was individual instructed to avoid cardiac stimulants such as alcohol, caffeine, nicotine, and some over-the-counter or prescription drugs?
  • Did individual follow the recommendations?

Regarding prognosis:

  • Does individual have any conditions that may affect recovery and prognosis?
  • Did individual suffer any complications, such as increased frequency of premature beats or disturbances in cardiac output associated with the premature beats, that may affect recovery and prognosis?

Source: Medical Disability Advisor



References

Cited

Pantano, J. A., and R. J. Oriel. "Prevalence and Nature of Cardiac Arrhythmias in Apparently Normal Well-trained Runners." American Heart Journal 104 4 Pt 1 (1982): 762-768.

Stahmer, Sarah. "Premature Ventricular Contraction." eMedicine. Eds. Assaad J. Sayah, et al. 21 Jan. 2002. Medscape. 13 Oct. 2004 <http://emedicine.com/emerg/topic773.htm>.

Source: Medical Disability Advisor






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