Heart Failure Impairment Online Questionnaire
Heart Failure Impairment Printable Questionnaire
Heart failure (HF) is a clinical syndrome where the heart muscle fails to provide an adequate amount of oxygen carrying blood flow to meet the body's demand. HF can be caused by left or right ventricular dysfunction. Left-sided heart failure is often characterized by symptoms of shortness of breath and rales (crackles heard at the lung base). Right-sided heart failure is associated with peripheral edema. Most frequently, right and left heart failure occur together.
The most common cause of HF is ischemic cardiomyopathy of coronary artery disease, which enlarges the ventricles. Other common causes of heart failure include poorly controlled hypertension, myocarditis, cardiomyopathy, valve disease, and hyperthyroidism.
Drug therapy is the primary HF treatment. Underlying conditions such as hypertension, coronary artery disease, and arrhythmia must be treated. Medications including diuretics and digoxin may be needed. Surgical treatment of heart failure may include pacemaker and defibrillator implants, coronary artery bypass or angioplasty, and repair of congenital heart and valvular heart disorders. The signs and symptoms of heart failure can improve and may disappear when HF is controlled and compensated, but this control does not cure the underlying cause of the failure. Some forms of heart failure may be curable such as right heart failure due to pulmonary embolism which generally resolves after treatment of the embolism.
Underwriting guidelines for heart failure are: | |
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Heart failure, present, right or left |
Decline |
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History of left heart failure (with or without right heart failure), due to cardiac disease, recovered |
Postpone 1 year. Thereafter with stable or rising ejection fraction (EF) enter table: |
Left heart failure (with or without right heart failure), due to non-cardiac disease, recovered |
Rate for cause only |
Left and right heart failure, due to congenital heart diseaseor valve disease, surgically repaired and fully recovered. |
Rate for cause only |
Right heart failure without left heart failure: |
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Acute, due to pulmonary embolism, recovered |
Rate for the greater of cause, residual impairment or therapy. (Current anticoagulant therapy is Table B.) |
Acute, due to myocardial infarction, recovered |
Rate as Myocardial Infarction (Rx #14) |
Chronic or others |
Individual Consideration |