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7110
§ 4.104 Schedule of ratings—cardiovascular system.

Aortic aneurysm

A bulge in the wall of the aorta, the body's main artery, that may rupture.

What the rating means

VA rates aortic aneurysm of the ascending, thoracic, or abdominal aorta under Diagnostic Code 7110. There are two possible ratings before surgery: 100% or 0%. You receive a 100% rating if your aneurysm measures five centimeters or larger in diameter, causes symptoms such as precluding exertion, or requires surgery. If none of those conditions are met, the rating is 0%.

When a physician recommends surgical correction, the 100% evaluation begins on the date of that recommendation. After surgery, VA requires an examination six months after hospital discharge. Post-surgical residuals of the heart are then rated under the General Rating Formula for Diseases of the Heart, which uses four levels: 100%, 60%, 30%, and 10%. That formula separates ratings by the workload, measured in METs, at which heart failure symptoms such as breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope develop. Non-cardiovascular residuals from surgery are rated separately under the organ systems affected. Any rating change after the six-month exam is subject to the protections of 38 CFR § 3.105(e).

Evidence that helps

For a pre-surgical 100% rating, medical records documenting the aneurysm's size are central. Imaging such as CT scans, MRI, or ultrasound reports that measure the aneurysm at five centimeters or larger in diameter directly address one criterion. Records showing symptoms that prevent exertion, or a physician's written recommendation for surgical correction, satisfy the other criteria.

For post-surgical ratings under the General Rating Formula, exercise stress test results that report the MET level at which heart failure symptoms appear are the key evidence. Echocardiogram, multigated acquisition scan, or MRI findings showing cardiac hypertrophy or dilatation support a 30% rating even without a MET finding. Prescription records showing continuous medication is required for control support a 10% rating. If exercise testing cannot be done for medical reasons, a medical examiner's written estimate of the MET level — supported by specific activity examples such as slow stair climbing — can be used instead. Statements from you or those who know you describing how symptoms affect physical activity and daily tasks can help show the level of exertion that triggers those symptoms.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.