Employees with Heart 

Conditions 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

The Job Accommodation Network (JAN) is a service of the Office of Disability 

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The information is not intended to be legal or medical advice. If legal or medical advice 

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contact JAN. 

Authored by Beth Loy, Ph.D. Updated 03/22/10. 
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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Heart Conditions 

How prevalent are heart conditions? 

Over 70 million Americans have heart conditions, amounting to one in four men and 

women. Looking at specific age groups, cardiovascular disease from a heart condition is 

the number one disease affecting individuals ages 65 and older, second for ages 25 

through 64, third for ages zero through 14, and fifth for ages 15 through 24. One in five 

males and females are affected: one in three men and one in 10 women (American 

Heart Association, 2005). 

What are heart conditions? 

The majority of heart conditions are diagnosed as high blood pressure. Coronary heart 

disease, congenital heart failure, and stroke are also prominent. Heart valve 

abnormalities, congestive heart failure, enlarged heart, murmurs, hypertension, marfan 

syndrome, and rheumatic fever may also contribute to a heart condition. Congenital 

cardiovascular defects, present in about one percent of live births, may be other causes 

(American Heart Association, 2005). 

What are the symptoms of a heart condition?

Each type of heart condition has its own set of indicators and most symptoms could be 

caused by other conditions. Also, some heart conditions may have no noticeable effects 

and may develop differently in women than in men. Women's symptoms may progress 

over a much longer period of time and also be subtler than men's symptoms. Symptoms 

may include: 
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• angina (chest pain sometimes radiating down the left arm or into the jaw); 

• sensations of fluttering, thumping, pounding, or racing of the heart (palpitations); 

• edema (swelling and fluid retention in the legs, ankles, abdomen, lungs, or 

heart); 

• lightheadedness, weakness, dizziness, or fainting spells; 

• breathlessness; 

• chronic fatigue; and 

• gastric upset (or nausea) (American Heart Association, 2005). 

What causes heart conditions? 

Men over 45 years old and women over 55 years old, or women who have passed 

menopause or had their ovaries removed, have a greater chance of being diagnosed 

with heart conditions. Other increased risk factors for heart conditions include: 

• high blood cholesterol/blood pressure, 

• physical inactivity, 

• excess body weight, 

• diabetes, 

• coronary artery disease, 

• abnormal heartbeat, 

• carotid artery damaged by atherosclerosis, 

• family history of having a close blood relative who had a heart attack or stroke 

before age 55 (if father or brother) or before age 65 (if mother or sister), 

• smoking, excessive drinking, drug abuse, and poor diet (American Heart 

Association, 2005). 

How are heart conditions treated? 

Depending upon what type of heart condition an individual has, surgery, drugs, 

exercise, diet modification, or a transplant may be options (American Heart Association, 

2005). 

Heart Conditions and the Americans with Disabilities Act 

Is a heart condition a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC, 1992). Therefore, some people with heart conditions will have a disability under 

the ADA and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (EEOC, 1992). For more information about how to 

determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm.
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Accommodating Employees with Heart Conditions

(Note: People with heart conditions may develop some of the limitations discussed 

below, but seldom develop all of them. Also, the degree of limitation will vary among 

individuals. Be aware that not all people with heart conditions will need 

accommodations to perform their jobs and many others may only need a few 

accommodations. The following is only a sample of the possibilities available. 

Numerous other accommodation solutions may exist.) 

Questions to Consider: 

1. What limitations is the employee with the heart condition experiencing? 

2. How do these limitations affect the employee and the employee’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the employee with the heart condition been consulted regarding possible 

accommodations? 

6. Once accommodations are in place, would it be useful to meet with the employee 

with the heart condition to evaluate the effectiveness of the accommodations and to 

determine whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding heart conditions? 

Accommodation Ideas: 

Fatigue/Weakness: 

• Reduce or eliminate physical exertion 

• Schedule periodic rest breaks away from the workstation 

• Allow a flexible work schedule and flexible use of leave time 

• Allow work from home 

• Implement ergonomic workstation design 

• Provide a scooter or other mobility aid if walking cannot be reduced 

• Provide parking close to the work-site 

• Install automatic door openers 

• Move workstation close to other work areas, office equipment, and break rooms 

• Provide mechanical assists and lifting aids 
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Respiratory Difficulties: 

• Provide adjustable ventilation 

• Keep work environment free from dust, smoke, odor, and fumes 

• Implement a "fragrance-free" workplace policy and a “smoke free” building policy 

• Avoid temperature extremes 

• Use fan/air-conditioner or heater at the workstation 

• Redirect air conditioning and heating vents 

• Provide adequate exhaust systems to remove fumes from office machines 

• Allow individual to wear a respirator mask 

• Allow work from home 

Seizure Activity and Blackouts: 

• Eliminate the need to use sharp objects 

• Eliminate blinking and flickering lights 

• Replace fluorescent lighting with full spectrum or natural lighting 

• Use computer monitor glare guards, adjust monitor intensity and color, and 

decrease the cursor speed of the mouse 

• Provide protective clothing/equipment 

• Modify job tasks requiring fine finger dexterity 

• Allow flexible work hours

• Allow periodic rest breaks

• Allow work from home

Stress: 

• Develop strategies to deal with work problems before they arise 

• Provide sensitivity training to coworkers 

• Allow telephone calls during work hours to doctors and others for support 

• Provide information on counseling and employee assistance programs 

• Reduce workplace stress 

 

Temperature Sensitivity: 

• Modify work-site temperature 

• Modify dress code 

• Use fan/air-conditioner or heater at the workstation 

• Allow flexible scheduling and flexible use of leave time 

• Allow work from home during extremely hot or cold weather 

• Maintain the ventilation system 

• Redirect air conditioning and heating vents 

• Provide an office with separate temperature control 
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Situations and Solutions: 

A locomotive operator with myocardial infarction experienced reduction in stamina 

exacerbated by working midnight shifts. The employer required that he work only day 

and afternoon shifts to accommodate his restrictions. 

A supervisor with heart disease was limited in the level of physical activity he could 

exert. The individual was relieved of marginal functions involving manual labor. 

A maintenance technician, restricted from working in extreme temperatures, was 

accommodated with a modified schedule not requiring her to work outside in these 

conditions. 

An assembly line worker with congestive heart failure and chronic obstructive 

pulmonary disease was restricted to sedentary work and no lifting in excess of 15 

pounds. The assembly line job, which could not be modified, required both standing and 

lifting over 15 pounds. The individual was accommodated with a transfer to a sedentary 

job. 

A receiving clerk with a congenital heart defect was limited in her ability to perform 

strenuous activity. She was accommodated by having merchandise placed in smaller 

boxes and being provided a height adjustable material lift to help retrieve elevated 

boxes. The employer also gave her a reserved parking space closer to the building and 

allowed another employee to fill out her time card, minimizing walking and stair 

climbing. 

An individual, who delivered mail in a high-rise office building had high blood pressure 

and was limited to no lifting and pushing over 25 pounds. The employer provided the 

individual with a power cart and compact lifting devices to assist with moving materials. 

Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, upon request JAN provides these 

lists and many more that are not available on the Web site. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

American Heart Association 

7272 Greenville Avenue 

Dallas, TX 75231 

Toll Free: (800)242-8721 

http://www.americanheart.org 

The American Heart Association is dedicated to providing education and information on 

fighting heart disease and stroke. 
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Centers for Disease Control and Prevention 

1600 Clifton Rd NE 

Atlanta, GA 30333 

Toll Free: (800)311-3435 

Direct: (404)498-1515 

http://www.cdc.gov 

The Centers for Disease Control and Prevention are dedicated to protecting the health 

and safety of people - at home and abroad, providing credible information to enhance 

health decisions, and promoting health through strong partnerships. 

Heart Information Service 

1655 N Fort Myer Drive 

Suite 400 

Arlington, VA 22209 

Fax: (703)248-0830 

Phone: (703)302-1040 

http://www.healthcentral.com/heart-disease/ 

HeartInfo is an independent, educational service that provides a wide range of 

information and services to heart patients and others interested in learning about 

lowering risk factors. 

Heart and Stroke Foundation of Canada 

222 Queen Street, Suite 1402 

K1P 5V9 

Ottawa, ON 

Direct: (613)569-4361 

Fax: (613)569-3278 

http://www.heartandstroke.ca 

The mission of the Heart and Stroke Foundation of Canada is to further the study, 

prevention, and reduction of disability and death from heart disease and stroke through 

research, education, and the promotion of healthy lifestyles. 

InterAmerican Heart Foundation 

7272 Greenville Ave 

Dallas, TX 75231-4596 

Fax: (214)706-1211 

Phone: (214)706-1301 

Phone: (972)562-3806 

iahf@interamericanheart.org 

http://www.interamericanheart.org 

The InterAmerican Heart Foundation is dedicated to reducing disability and death from 

cardiovascular diseases and stroke in the Americas. 
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National Heart, Lung, and Blood Institute 

NHLBI Health Information Center 

Attention: Web Site 

P.O. Box 30105 

Bethesda, MD 20824-0105 

Direct: (301)592-8573 

TTY: (240)629-3255 

Fax: (240)629-3246 

nhlbiinfo@nhlbi.nih.gov 

http://www.nhlbi.nih.gov 

The National Heart, Lung, and Blood Institute (NHLBI) provides leadership for a national 

program in diseases of the heart, blood vessels, lung, and blood. 

National Organization for Rare Disorders 

55 Kenosia Avenue 

PO Box 1968 

Danbury, CT 06813-1968 

Toll Free: (800)999-6673 

Direct: (203)744-0100 

TTY: (203)797-9590 

Fax: (203)798-2291 

orphan@rarediseases.org 

http://www.rarediseases.org/ 

NORD is a unique federation of voluntary health organizations dedicated to helping 

people with rare "orphan" diseases and assisting the organizations that serve them. 

NORD is committed to the identification, treatment, and cure of rare disorders through 

programs of education, advocacy, research, and service. 
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References 

American Heart Association. (2005). Heart disease and stroke statistics — 2005 update. 

Retrieved September 3, 2008, from 

http://www.americanheart.org/downloadable/heart/1105390918119HDSStats200

5Update.pdf 

Equal Employment Opportunity Commission. (1992). A technical assistance manual on 

the employment provisions (title I) of the Americans with Disabilities Act. 

Retrieved September 3, 2008, from http://askjan.org/links/ADAtam1.html 
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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.