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Class I: No limitation of
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physical activity. Ordinary
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physical activity does not
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cause undue fatigue,
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dyspnea, or anginal pain.
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Class II: Slight limitation of
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physical activity. Ordinary
|
physical activity results in
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symptoms.
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Class III: Marked limitation
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of physical activity.
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Comfortable at rest, but
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less than ordinary activity
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causes symptoms.
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Class IV: Unable to
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engage in any physical
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activity without discomfort.
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Symptoms may be present
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even at rest.
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Secondary Pulmonary
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Hypertension
|
Secondary pulmonary
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hypertension with
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established right
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ventricular hypertrophy
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leading to the presence of
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permanent physical
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impairment of at least
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Class IV of the New York
|
Heart Association (NYHA)
|
Classification of Cardiac
|
Impairment.
|
The NYHA Classification
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of Cardiac Impairment:
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Class I: No limitation of
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physical activity. Ordinary
|
physical activity does not
|
cause undue fatigue,
|
dyspnea, or anginal pain.
|
Class II: Slight limitation of
|
physical activity. Ordinary
|
physical activity results in
|
symptoms.
|
Class III: Marked limitation
|
of physical activity.
|
Comfortable at rest, but
|
less than ordinary activity
|
causes symptoms.
|
Class IV: Unable to
|
engage in any physical
|
activity without discomfort.
|
Symptoms may be present
|
even at rest.
|
31.
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Progressive
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Scleroderma
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Early Progressive
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Scleroderma
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A rheumatologist must
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make the definite
|
diagnosis of progressive
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systemic scleroderma,
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based on clinically
|
accepted criteria. This
|
diagnosis must be
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unequivocally supported
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by biopsy and serological
|
evidence.
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The following are
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excluded:
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• localised scleroderma
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(linear scleroderma or
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morphea);
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• eosinophilic fasciitis;
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and
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• CREST syndrome
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Progressive
|
Scleroderma with
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CREST syndrome
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A rheumatologist must
|
make the definite
|
diagnosis of systemic
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sclerosis with CREST
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syndrome, based on
|
clinically accepted criteria.
|
This diagnosis must be
|
unequivocally supported
|
by biopsy and serological
|
evidence. The disease
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must involve the skin with
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deposits of calcium
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(calcinosis), skin
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thickening of the fingers or
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toes (sclerodactyly) and
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also involve the
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esophagus. There must
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