Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104
Endocarditis is infection or inflammation of the inner lining of the heart, particularly the heart valves, most commonly caused by bacteria. The VA rates this at 100% during the active infection plus three months after therapy ends. After that window, the rating shifts to the General Rating Formula for Diseases of the Heart (38 CFR § 4.104), based on MET-tolerance during exercise testing and any structural changes such as cardiac hypertrophy or dilatation. Diagnosis must be confirmed by physical examination AND echocardiogram (or Doppler echocardiogram or cardiac catheterization).
Rating levels
- 100% — You qualify for 100% during active endocarditis with cardiac involvement, AND for three months following the end of therapy for the active infection. The 100% rating bridges the acute treatment phase plus a 3-month recovery window. After that 3-month window, the rating transitions to the General Rating Formula for Diseases of the Heart tiers below, based on workload tolerance and any cardiac structural changes.
- 100% — You qualify for 100% under the General Rating Formula for Diseases of the Heart if exercise testing (or a clinically equivalent assessment) shows that a workload of 3.0 METs or less brings on heart failure symptoms such as dyspnea, fatigue, angina, dizziness, or syncope. 3.0 METs is roughly equivalent to slow walking on a level surface, so this rating means even minimal activity provokes symptoms. Diagnosis must be confirmed by physical examination AND echocardiogram, Doppler echocardiogram, or cardiac catheterization.
- 60% — You qualify for 60% if exercise testing (or clinical equivalent) shows that a workload of 3.1 to 5.0 METs brings on heart failure symptoms (dyspnea, fatigue, angina, dizziness, or syncope). The 3-5 MET range covers activities like light housework, slow walking, and dressing. Diagnosis must be confirmed by physical examination AND echocardiogram, Doppler echocardiogram, or cardiac catheterization.
- 30% — You qualify for 30% if a workload of 5.1 to 7.0 METs brings on heart failure symptoms, OR if you have echocardiographic evidence of cardiac hypertrophy (thickening of the heart muscle) or dilatation (enlargement of the heart chambers), confirmed by echocardiogram, Doppler echocardiogram, MUGA scan, or cardiac MRI. The 5-7 MET range covers brisk walking, climbing stairs at a normal pace, and light cycling, so symptoms at this level mean moderate activity provokes them.
- 10% — You qualify for 10% if a workload of 7.1 to 10.0 METs brings on heart failure symptoms, OR if you require continuous medication (such as antiarrhythmics, anti-inflammatories like colchicine for recurrent pericarditis, or other cardiac medications) to keep symptoms under control. The 7-10 MET range covers heavier exertion like jogging, vigorous cycling, or carrying heavy loads upstairs.