Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104DBQ: DBQ CARDIO Heart
Arteriosclerotic heart disease (coronary artery disease) is narrowing or blockage of the coronary arteries from atherosclerosis (plaque buildup), the most common form of heart disease, often manifesting as angina, myocardial infarction, or heart failure.. The VA rates this condition under a CAD-specific variant of the General Rating Formula for Diseases of the Heart (38 CFR § 4.104, DC 7005), with the same MET-based ladder PLUS additional criteria specific to CAD: chronic congestive heart failure or LVEF <30% supports 100%; more than one acute CHF episode in the past year or LVEF 30-50% supports 60%; cardiac hypertrophy or dilatation on imaging supports 30%; continuous medication for control supports 10%.
Rating levels
- 100% — You qualify if you have chronic congestive heart failure (when your heart can't pump blood effectively, causing fluid buildup in your lungs and body), or if very light activities like slow walking cause you to experience shortness of breath, extreme tiredness, chest pain, dizziness, or fainting. You also qualify if tests show your heart's main pumping chamber (left ventricle) is working at less than 30 percent of normal capacity.
- 60% — You qualify for this rating if you've had more than one episode of acute congestive heart failure (when your heart can't pump blood effectively, causing fluid buildup) in the past year. You also qualify if light to moderate physical activity like walking 2-3 mph or doing light housework causes you to experience shortness of breath, fatigue, chest pain, dizziness, or fainting. Additionally, you qualify if tests show your heart's left ventricle (main pumping chamber) has reduced function with an ejection fraction between 30-50 percent, meaning your heart only pumps out 30-50% of the blood it contains with each beat instead of the normal 55-70%.
- 30% — You qualify for this rating if moderate physical activity causes you to experience shortness of breath, fatigue, chest pain, dizziness, or fainting. Moderate activity means things like walking briskly, climbing stairs, or doing yard work that makes your heart work harder than light activities but isn't extremely strenuous. You also qualify if medical tests like an EKG, echocardiogram, or chest X-ray show that your heart's main pumping chamber isn't working properly and has become enlarged or thickened.
- 10% — You qualify for this rating if moderate physical activities like jogging, climbing several flights of stairs, or doing heavy yard work cause you to experience shortness of breath (dyspnea), unusual tiredness (fatigue), chest pain (angina), dizziness, or fainting (syncope). You also qualify if you need to take heart medication every day to manage this condition.