Manual of the Medical Department (NAVMED P-117): Chapter 15: Medical Examinations: Physical Standards

15-43 Heart

Department of the Navy
Bureau of Medicine and Surgery

(a) Valvular heart diseases including those improved by surgery, except for mitral valve prolapse and congenital bicuspid aortic valve, unless hemodynamically significant a associated with arrhythmia.

(b) Obstructive coronary artery disease or myocardial infarction, old or recent or true angina pectoris at any time.

(c) Electrocardiographic evidence of major arrhythmias or conduction defects such as

(1) Atrial flutter, or fibrillation. Ventricular tachycardia, fibrillation or multifocal premature ventricular contractions, unless a single episode and there has been no recurrence or required medication for 2 years.

(2) First degree atrio-ventricular (A-V) block and right bundle branch block occurring as isolated findings are not disqualifying when cardiac evaluation reveals no cardiac disease.

(3) Left bundle branch block, 2nd and 3rd degree A-V block, and other conduction disturbances which can be associated with underlying cardiovascular disease.

(4) Unequivocal electrocardiographic evidence of old or recent myocardial infarction; coronary insufficiency at rest or after stress; a evidence of cardiomyopathy.

(5) Electrocardiographic evidence of accelerated A-V conduction in asymptomatic individuals, unless shown to be of acceptably low risk by appropriate (generally electrophysiologic) studies.

(d) Hypertrophy or dilatation of the heart as evidenced by clinical, x-ray, echocardiographic, or other examination.

(e) Myocardial insufficiency (congestive circulatory failure, cardiac decompensation) obvious a coven, regardless of cause.

(f) Paroxysmal tachycardia within the preceding 5 years, or at any time if recurrent or disabling w if associated with electrocardiographic evidence of accelerated A-V conduction (Wolff-Parkinson-White).

(g) Pericarditis; endocarditis; a myocarditis, history w finding of, except for a history of a single acute idiopathic or coxsackie pericarditis it is with no residuals , or tuberculous pericarditis adequately treated with no residuals and inactive for 2 years.

(h) Tachycardia persistent with a resting pulse rate of 100 a more, regardless of cause.