Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104
Pericardial adhesions is scar-tissue bands that form between the pericardium (the sac around the heart) and the heart muscle, typically after pericarditis, cardiac surgery, or trauma. The adhesions can restrict normal heart movement and reduce cardiac output.. The VA rates this condition under the General Rating Formula for Diseases of the Heart (38 CFR § 4.104) from 10% to 100% based on the MET workload at which heart failure symptoms appear (dyspnea, fatigue, angina, dizziness, or syncope) and the presence of cardiac structural changes such as hypertrophy or dilatation on imaging. Continuous cardiac medication required for control supports a 10% rating.
Rating levels
- 100% — You qualify for 100% 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 (shortness of breath), fatigue, angina (chest pain), dizziness, or syncope (fainting). 3.0 METs is roughly equivalent to slow walking on a level surface, so this rating means even minimal activity provokes symptoms.
- 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.
- 30% — You qualify for 30% if a workload of 5.1 to 7.0 METs brings on heart failure symptoms, OR if you have 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.
- 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 beta blockers, ACE inhibitors, anti-anginal medications, or other cardiac drugs) to keep symptoms under control. The 7-10 MET range covers heavier exertion like jogging, vigorous cycling, or carrying heavy loads upstairs.