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Ischemic and Congenital Heart Disease

Severe Heart Disease

Service-Connected Heart Disease

Both ischemic heart disease, better known as coronary artery disease, and congenital heart disease are recognized by the Department of Veterans Affairs as potential service-connected impairments. In particular, ischemic heart disease has been linked to Agent Orange exposure. For this reason, veterans who have been exposed to Agent Orange are not required to prove a connection between their ischemic heart disease and their service in the military in order to claim veterans disability compensation benefits.

While congenital heart disease is a genetic disease, meaning that certain individuals are predisposed genetically to coronary blockages and/or cardiac arrest, it can still be a service-connected condition if it becomes symptomatic during a veteran’s time in military srevice.

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If you or a loved one served in the military and are now suffering from severe heart disease, please contact our office for a free consultation. You can reach our office by phone at 800-742-5035 or use the contact form on this site.

§4.104 Schedule of Ratings-Cardiovascular system

DISEASES OF THE HEART

Note 1: Evaluate cor pulmonale, which is a form of secondary heart disease, as part of the pulmonary condition that causes it.

Note 2: One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used.

7000 Valvular heart disease (including rheumatic heart disease):

During active infection with valvular heart damage and for three
months following cessation of therapy for the active infection 100

Thereafter, with valvular heart disease (documented by findings on
physical examination and either echocardiogram, Doppler
echocardiogram, or cardiac catheterization) resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope,
or; left ventricular dysfunction with an ejection fraction of
less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year, or; workload of greater than 3 METs but not greater than
5 METs results in dyspnea, fatigue, angina, dizziness, or syncope,
or; left ventricular dysfunction with an ejection fraction of
30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electro-cardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

7001 Endocarditis:

For three months following cessation of therapy for active infection
with cardiac involvement 100

Thereafter, with endocarditis (documented by findings on physical
examination and either echocardiogram, Doppler echocardiogram,
or cardiac catheterization) resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of less than
30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
continuous medication required 10

7002 Pericarditis:

For three months following cessation of therapy for active infection
with cardiac involvement 100

Thereafter, with documented pericarditis resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of less
than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electro-cardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

7003 Pericardial adhesions:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year, or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or; left
ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electro-cardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

7004 Syphilitic heart disease:

Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of less
than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

Note: Evaluate syphilitic aortic aneurysms under DC 7110 (aortic aneurysm).

7005 Arteriosclerotic heart disease (Coronary artery disease):

With documented coronary artery disease resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or; left
ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

Note: If nonservice-connected arteriosclerotic heart disease is superimposed on service-connected valvular or other non-arteriosclerotic heart disease, request a medical opinion as to which condition is causing the current signs and symptoms.

7006 Myocardial infarction:

During and for three months following myocardial infarction,
documented by laboratory tests 100

Thereafter:

With history of documented myocardial infarction, resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of less
than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
continuous medication required 10

7007 Hypertensive heart disease:

Chronic congestive heart failure, or; workload of 3 METs or less
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of less
than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

7008 Hyperthyroid heart disease:

Include as part of the overall evaluation for hyperthyroidism under
DC 7900. However, when atrial fibrillation is present, hyperthyroidism
may be evaluated either under DC 7900 or under DC 7010
(supraventricular arrhythmia), whichever results in a higher evaluation.

7010 Supraventricular arrhythmias:

Paroxysmal atrial fibrillation or other supraventricular tachycardia, with
more than four episodes per year documented by ECG or Holter
monitor 30

Permanent atrial fibrillation (lone atrial fibrillation), or; one to four
episodes per year of paroxysmal atrial fibrillation or other
supraventricular tachycardia documented by ECG or
Holter monitor 10

7011 Ventricular arrhythmias (sustained):

For indefinite period from date of hospital admission for initial evaluation
and medical therapy for a sustained ventricular arrhythmia, or; for
indefinite period from date of hospital admission for ventricular
aneurysmectomy, or; with an automatic implantable Cardioverter-
Defibrillator (AICD) in place 100

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or; left
ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results in
dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or;
continuous medication required 10

Note: A rating of 100 percent shall be assigned from the date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter.

7015 Atrioventricular block:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication or a pacemaker required 10

Note: Unusual cases of arrhythmia such as atrioventricular block associated with a supraventricular arrhythmia or pathological bradycardia should be submitted to the Director, Compensation Service. Simple delayed P-R conduction time, in the absence of other evidence of cardiac disease, is not a disability.

7016 Heart valve replacement (prosthesis):

For indefinite period following date of hospital admission for valve
replacement 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

Note: A rating of 100 percent shall be assigned as of the date of hospital admission for valve replacement. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter.

7017 Coronary bypass surgery:

For three months following hospital admission for surgery 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or; left
ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload greater than 7 METs but not greater than 10 METs results in
dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10

7018 Implantable cardiac pacemakers:

For two months following hospital admission for implantation or
reimplantation 100

Thereafter:

Evaluate as supraventricular arrhythmias (DC 7010), ventricular
arrhythmias (DC 7011), or atrioventricular block (DC 7015).
Minimum 10

Note: Evaluate implantable Cardioverter-Defibrillators (AICD’s) under DC 7011.

7019 Cardiac transplantation:

For an indefinite period from date of hospital admission for cardiac
transplantation 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60
Minimum 30

Note: A rating of 100 percent shall be assigned as of the date of hospital admission for cardiac transplantation. One year following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter.

7020 Cardiomyopathy:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication required 10