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7000
§ 4.104 Schedule of ratings—cardiovascular system.

Valvular heart disease

A condition affecting one or more heart valves that may disrupt blood flow through the heart.

What the rating means

Valvular heart disease, including rheumatic heart disease, is rated under diagnostic code 7000. During an active infection with cardiac involvement and for three months after therapy ends, the rating is 100%. After that period, your diagnosis must be confirmed by physical examination and at least one of the following: echocardiogram, Doppler echocardiogram, or cardiac catheterization. VA then rates the condition using the General Rating Formula for Diseases of the Heart.

That formula is based on the level of physical exertion, measured in METs (metabolic equivalents), at which heart failure symptoms appear. One MET equals the energy your body uses standing quietly at rest. A workload of 3.0 METs or less causing symptoms rates 100%. A workload of 3.1 to 5.0 METs rates 60%. A workload of 5.1 to 7.0 METs, or confirmed cardiac hypertrophy or dilatation on echocardiogram or equivalent imaging, rates 30%. A workload of 7.1 to 10.0 METs causing symptoms, or a need for continuous medication to control the condition, rates 10%. Heart failure symptoms include breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, and syncope, among others.

Evidence that helps

Medical records that document the confirmed diagnosis are the foundation of a rating. For the initial 100% period, records showing an active infection with cardiac involvement and the dates therapy began and ended are key. After that, VA looks for physical examination findings alongside an echocardiogram, Doppler echocardiogram, cardiac catheterization, or equivalent imaging such as a multigated acquisition scan or MRI showing cardiac hypertrophy or dilatation.

Exercise test results that record the MET level at which your symptoms appear directly support the rating criteria. If exercise testing cannot be done for medical reasons, a medical examiner can estimate your activity tolerance in METs based on specific examples, such as slow stair climbing. Records of continuous prescription medication to control the condition support the 10% level. Statements from you or people who know you describing when symptoms like breathlessness, fatigue, dizziness, or syncope occur during daily activities can help connect your functional limits to the MET thresholds in the rating formula.

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.