Echocardiogram

[Ron II]

Ron, if you meet the criteria for a higher rating for heart disease, It should be a no brainer. The Ratings are based on Test results and the ratings are based on the Ejection fraction, Congestive Heart Failure and other information. The most significant test is a Cardiac Catherization. It is an actual person looking inside and taking the measurements.

For example, You have a heart Echo and your EF is 55 percent, You then have a heart cath and it shows your EF at 50 percent. The VA has to go with the Heart cath. It overrides other test results.

J

Hi Jbasser,

I don't have the EF at the rates you mention, but the Echo showed LVH. Isn't that enough to receive a 30 percent rating? Please see the extract from my appeal below, which was partially written by our own Ricky .

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On January 23, 2008 an Echocardiogram (EC) was conducted by Colorado Springs Cardiologists and interpreted by Dr. David A*******. As a result of the testing, Dr. A****** provided a diagnosis of Concentric Left Ventricular Hypertrophy (LVH). This new evidence is an independent medical opinion/examination the VA did not have when they made the previous decision and the evidence bears directly on the issue of why it was previously denied. Your denial included the necessity (for a rating of more than 10 percent) for several medical values including, “A higher evaluation of 30 percent is not warranted unless...or evidence of cardiac hypertrophy or dilation on..., echocardiogram, or X-ray.”

The January 23, 2008 Echocardiogram is the most accurate assessment of my current level of disability and actually supports my contention that my condition has become worse since my 2003 stress test. If nothing else, the new and material evidence shows Concentric Left Ventricular Hypertrophy (LVH) on January 23, 2008. Additionally, since December 2003, there are two pieces of evidence now, the 6.2 METs evaluation and the LVH finding that support a 30 percent rating. It seems that “...reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present .”--now portrays a picture involving multiple tangible medical views warranting 30 percent, and nothing tangible since 2003 that supports a 10 percent rating.

Although my 2003 METs pre-dates my original claim by several years, it does provide a bookend along with the Echocardiogram (which directly bears on the level of disability) to support a higher rating, especially since

no other tests were done between the two elements—past medical report and current finding. As stated above,

the “consistent picture” is tangible.

-----------------

Ron

p.s.

I don't think I have a case for retro past January 23, 2008, but it seems that date should be approved at 30-percent without a problem. For my heart, I am currently rated at 10 percent for cardiac pacemaker. That rating was made retro to my claim of Aug 2006.

[carlie]

Hey Ron,

I'm not jbasser just sharing info..

6 years ago my EF was 36 % and I really felt like crap, digoxin had

so many side effects, I'm off that and doing better now.

This doesn't answer your question, just kind of letting you

know health wise - I know how you feel, I'm always tired.

carlie

Edited April 29, 2008 by carlie
triple posted

[cowgirl]

what does 40% ef mean

Thanks Cg

[68chstiger]

EF =

ejection factor- they measure how well the left ventricle is pumping blood out. They told me that due to my heart attack that caused some heart muscle damage that my EF was 40%

68chstiger

[stillhere]

Correct and you are probably rated at at least 60% for heart disease right?

[Berta]

Ron- you might present a disability that is higher then the 30%:

from:http://www.va.gov/vetapp08/files1/0806493.txt

"The veteran's CAD has been rated as 30% disabling under the

provisions of 38 C.F.R. § 4.104, DC 7005. Under

that DC, a 30% rating is assigned when CAD is productive of a

workload of greater than 5 metabolic equivalents (METs) but

not greater than 7 METs that results in dyspnea, fatigue,

angina, dizziness, or syncope; or evidence of cardiac

hypertrophy or dilatation on electrocardiogram (EKG),

echocardiogram, or X-ray. A 60% rating requires more than 1

episode of acute congestive heart failure (CHF) in the past

year; or a workload of greater than 3 METs but not

greater than 5 METs that results in dyspnea, fatigue, angina,

dizziness, or syncope; or left ventricular dysfunction with

an ejection fraction (EF) of 30% to 50%. A 100% rating

requires chronic CHF; or a workload of 3 METs or less that

results in dyspnea, fatigue, angina, dizziness, or syncope;

or left ventricular dysfunction with an EF of less than 30%."

I was studying my husband's ECHO yesterday-it was instrumental when I proved the VA had never diagnosed my husband's heart disease.

There is a lot of information in an ECHO report-

atherosclerosis is evident and can be diagnosed in the way they measure dilations etc-

I have to assess (since Rod's heart attack and then progressive heart disease and fatal heart attack) was considered by VA as one of "multiple deviations" in his medical care- Section 1151 (a nice way of saying in the award letter that they killed him with malpractice)

the actual rating they should have given him.

One of my CUE claims is for lack of any rating or DC whatsoever for the main Section 1151 disability he had-undiagnosed and fatal untreated heart disease.

a bonafide CUE-obviously-

My point is- it might pay for you to access some BVA decisions to see how they determine these ratings for CAD-

the ECHO you have clearly shows the LVH and the dilation readings could also help prove your evidence warrants a much higher rating.

“A higher evaluation of 30 percent is not warranted unless...or evidence of cardiac hypertrophy or dilation on..., echocardiogram, or X-ray"

I think you might fit into the 60% criteria.

The ECHO report you have should have statements as to findings next to Aortic root,LA and LV chamber, statements as to any hypokinesis and Akinesis.

The M-Mode measurments should be there too.

I cant comment on anyones else's ECHO because I am not a doctor-I studied enough cardiology to prove (just counted them) with only 9 medical records (and autopsy)that the VA never diagnosed my husband's heart disease-they knew he had it-

they just never diagnosed or treated it,and covered it up- thinking no one would ever find out.

That ECHO you have might well show the dilation factor that the VA mentioned.

What is the 40% for- 10 for the Pacemaker- but how did they award 40%?

Edited April 29, 2008 by Berta

[Berta]

What I mean is I cannot diagnose any ECHO findings.

I can comment on the fact that if your ECHO shows dilations,this could put you into the 60% criteria-

Dilations can indicate atherosclerosis-VA does not recongnise atherosclerosis , in itself, as a ratable disability.

I just read this AM where in one BVA the veteran claimed atherosclerosis and was denied yet other veterans claimed resulting disabilities from atheroscleoris and were granted because their heart disease had already been established ,or their claim raised the heart issue ,which was service connected, and then added disabilities from atherosclerosis.

The last statement on my husband's ECHO was "No clots seen on this study."

He had suffered a CVA 4 weeks prior to this ECHO-it was misdiagnosed numerous times- until they determined -incorrectly-that he needed brain surgery-

you dont need brain surgery for the type of clot he had.

It was caused by severe dilation of arteries in the Left heart chamber-

I was reading medical books as fast as I could regarding his brain trauma from the CVA-I had to go toe to toe with Neurologists to get his stroke properly assessed-

My point here is that VA can treat arterial dilation-they do that all the time-

untreated dilation can produced clots that pass from the heart into the brain.Small clots cause transcient ischematic attacks- big clots can cause a major stroke.

If atherosclerosis isnt treated properly it can cause these additional disabilities which VA has to rate and if due to a SC heart condition,

they would have a heck of a time trying to prove that the disabilities from the atherosclerosis are not SC too.

You all have no idea how utterly angry and disgusted I am when I realise that the only person who diagnosed Rod with heart disease properly was me-

well the VA finally did too-they concurred with my findings-

years after he was dead.But the evidence was in his med recs for over 6 years and they just ignored it.