Skipping a Heartbeat Leading to Social Security Disability
The tempo of a heartbeat is determined by one's height, weight, and age. But when the standard “sinus rhythm” sounds strange, then an individual may be suffering from an arrhythmia. An arrhythmia occurs if the heart beats faster or slower or with a rhythm different from the standard “lub-dub.” Arrhythmias “occur when the electrical impulses in the heart that coordinate heartbeats don't work property.”
Arrhythmias may not cause any signs or symptoms. A doctor may find an arrhythmia before the individual feels anything. Some noticeable symptoms include:
- A fluttering in the chest
- A racing heartbeat (known as tachycardia)
- A slow heartbeat (known as bradycardia)
- Chest pain
- Shortness of breath
- Fainting or near fainting
Sometimes arrhythmias can be harmless, but one type of arrhythmia, ventricular fibrillation, tends to be fatal if not tended to quickly. Ventricular fibrillation “occurs when the heart beats with rapid, erratic electrical impulses. This causes the ventricles to quiver uselessly instead of pumping blood.”
“Many things can lead to, or cause, an arrhythmia, including:
- A heart attack as it is occurring
- Scarring of heart tissue from a prior heart attack
- Changes to the heart's structure, such as from cardiomyopathy (weakening of the heart muscle)
- Blocked arteries in the heart (coronary artery disease)
- High blood pressure
- Overactive thyroid gland (hyperthyroidism)
- Drinking too much alcohol or caffeine
- Drug abuse
- Dietary supplements and herbal treatments
- Electrical shock
- Air pollution
In addition to a full medical history, doctors use “heart-monitoring tests specific to arrhythmias.” The electrocardiogram (ECG) “measures the timing and duration of each electrical phase in the heartbeat.” For a longer ECG measure, a doctor may have an individual wear a Holter monitor for a day or more, which is a portable ECG. A doctor may have an individual keep an event monitor at home for an individual to use when they feel symptoms. A doctor may also use an echocardiogram to focus “sound waves [into the chest] to produce images of the heart's size, structure and motion.”
If those tests do not show that an individual has an arrhythmia, then other tests may be used. Sometimes a stress test will induce an arrhythmia for a doctor to observe the heart during the episode. If an individual suffered fainting spells, then a tilt table may be used to orient an individual from lying prone to standing up and record how the heart responds.
Finally there is electrophyciological testing and mapping where “thin, flexible tubes (catheters) tipped with electrodes are threaded through the blood vessels to a variety of spots within the heart. Once in place, the electrodes can map the spread of electrical impulses through the heart. In addition, a cardiologist can use the electrodes to stimulate the heart to beat at rates that may trigger – or halt – an arrhythmia. This allows the doctor to see the location of the arrhythmia and what may be causing it.”
Treatment for arrhythmia is dependent on the type of arrhythmia. “Usually [treatment] is required only if the arrhythmia is causing significant symptoms or if it is putting the individual at risk of a more serious arrhythmia or arrhythmia complication.”
For a slow heart rate (bradycardia), it is common to surgically implant a pacemaker “near the collarbone … with electrode-tipped wires run through blood vessels to the inner heart. If the heart rate is too slow or if it stops, the pacemaker sends out an electrical impulse to stimulate the heart to beat at a steady, proper rate.”
For fast heartbeats (tachycardias), there are a number of treatments. There are vagal maneuvers to try to shock the nervous system. Medications are used to reduce episode frequency and duration. Cardioversion, also known as defibrillation, is used to shock the heart externally into a regular rhythm. And there is also ablation therapy wherein catheters are positioned by the parts of the heart causing problems, destroying a small portion of heart tissue.
Instead of a pacemaker, a doctor may implant a cardioverter-defibrillator, which will stimulate a heart beating too slowly as well as a heart beating too quickly.
Social Security Disability
Many individuals who have arrhythmias are still able to function normally. In order for an arrhythmia to qualify as a condition severe enough for Social Security Disability, an individual must show that their arrhythmia is not reversible and must be uncontrolled despite a variety of treatments used, and that the individual has recurrent episodes of fainting or near fainting episodes despite treatment. Electrocardiography, either resting ECG or Holter monitor, results, are required to show proof of the arrhythmias.
SSD applications require extensive documentation on an applicant's medical condition. If you are considering applying for disability benefits, contact our experienced attorney to assist you.