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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Berta

What Ischemic Heart Disease

Question

Ischemic heart disease, as a new AO presumptive, will certainly bring many more Agent Orange claims into the VA system.

With proof of AO exposure these claims should be very easy for the VA to rate and award.

The biggest problem with these claims that I foresee is that the VA will not have adequate evidence to determine IHD as many vets with IHD might have CAD or CHF in their records as well as other medical terms that in fact mean IHD diagnosis -but maybe the VA could misinterpret this.Or a C & P doctor could opine inaccurately on this AO disease.

I was talking to notable Vets lawyer Doug Rosinki a few weeks ago ago who had answered a vets question as to CHF-Congestive Heart Failure -which may not be ischemic heart disease at all. In his opinion-as ischemia has certain medical facets unlike other types of cardiomyopathy.He is right.

Terms like atherosclerosis, hyperlipedimia, peripheral aterial disease are some key medical terms that might most l;ifely indicate the type of heart disease one could have is, in fact, ischemia.

IHD is a broad term and accounts for the most prevalent type of heart disease in the USA.

However the new regs hopefully will define this disease better and hopefully veterans will not have problems proving they have this type of heart disease due to AO exposure.

Caused by cholesterol deposits, which block arteries, ischemic (is-KEY-mic) heart disease, also called coronary artery disease or coronary heart disease, is still the single biggest cause of death in the United States, killing nearly 500,000 Americans each year. But the situation is changing. According to a study in the Sept. 25, 1998, New England Journal of Medicine, deaths from coronary heart disease dropped 28 percent among men and 31 percent among women between 1987 and 1994 alone. This drop is primarily due to improved care.

An estimated 14 million people in the United States have ischemic heart disease. Of these, as many as 4 million have few or no symptoms and are unaware that they are at risk for angina (angina pectoris), heart attack (myocardial infarction), or sudden death.

Angina Pectoris

Plaque deposits on the interior linings of the heart’s arteries lie at the root of <a href="http://www.acc.org/media/patient/chd/glossary.htm#angina">angina pectoris. The narrowed arteries prevent the heart from getting enough oxygen during exercise and the person experiences a chest pain beneath the breast bone—this pain is called angina pectoris. Mild or intense, the discomfort usually lasts only a few minutes. Every year, an estimated 350,000 new cases of angina occur. Today, angina pectoris can be dramatically reduced or eliminated by medications, heart surgery, or balloon dilation of narrowed arteries.”

From:http://www.acc.org/media/patient/chd/ischemic.htm

“Silent Ischemia and Ischemic Heart Disease

What is ischemia?

Ischemia (is-KE'me-ah) is a condition in which the blood flow (and thus oxygen) is restricted to a part of the body. Cardiac ischemia is the name for lack of blood flow and oxygen to the heart muscle.

What is ischemic heart disease?

It's the term given to heart problems caused by narrowed heart arteries. When arteries are narrowed, less blood and oxygen reaches the heart muscle. This is also called coronary artery disease and coronary heart disease. This can ultimately lead to heart attack.

Ischemia often causes chest pain or discomfort known as angina pectoris (AN'jih-nah or an-JI'nah PEK'tor-is).

What is silent ischemia?

As many as 3 to 4 million Americans may have ischemic episodes without knowing it. These people have ischemia without pain — silent ischemia. They may have a heart attack with no prior warning. People with angina also may have undiagnosed episodes of silent ischemia. In addition, people who have had previous heart attacks or those with diabetes are especially at risk for developing silent ischemia.

Having an exercise stress test or wearing a Holter monitor – a battery-operated portable tape recording that measures and records your electrocardiogram (e-lek"tro-KAR'de-o-gram [ECG]) continuously, usually for 24-48 hours – are two tests often used to diagnose this problem. Other tests also may be used.

From:http://www.americanheart.org/presenter.jhtml?identifier=4720

Ischemic cardiomyopathy results when the arteries that bring blood and oxygen to the heart are blocked. There may be a buildup of cholesterol and other substances, called plaque, in the arteries that bring oxygen to heart muscle tissue. Over time, the heart muscle does not work well, and it is more difficult for the heart to fill and release blood.

Ischemic cardiomyopathy is a common cause of congestive heart failure. Patients with this condition may at one time have had a heart attack, angina, or unstable angina. A few patients may not have noticed any previous symptoms.

Ischemic cardiomyopathy is the most common type of cardiomyopathy in the United States. It affects approximately 1 out of 100 people, most often middle-aged to elderly men.”

From:

http://www.nlm.nih.gov/medlineplus/ency/article/000160.htm

also

Diabetic ischemic cardiomyopathy can cause a heart attack without a level of pain that would indicate heart attack. An EKG can immediately reveal whether this was silent ischemic heart attack or not.

Also severe peripheral neuropathy and arterial disease is another factor that can limit the amount of pain a heart attack victim can have.

None of this information is meant to alarm anyone.

But we and our significant others need to be aware of these things.

And AO vets filing for Ischemic heart disease might find this information helpful.

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Hello Berta:

I filed ischemic heart on oct 13, 2009. in my medical records sent to va with application there is records of pad. in the records dated 08/22/02 (heart bypass surgery was 05/23/2002) states impression 1. the right to left fem-fem bypass graft is occluded and there is recurrence of ischemic type flow to the entire left lower extremity, dr. bridges was informed of the findings.

Question should I have filed seperatly for pad or will it be considered with the ischemic heart?

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So what is the requirement for a VA Disablity Rating for Ischemic Heart Disease. I have been prescribed Simvastatin 80MG Tab once daily to lower cholesterol and Fish Oil (Sea Omega) 1000MG Cap twice daily to lower cholesterol, by my VA doctor, for the past ten years. So does this qualify for the VA Disability Rating, or does anyone really know?

" ischemic heart disease — A serious problem caused by inadequate circulation of blood to the heart muscle. Blood flow to the heart is blocked by obstructions of heart arteries by cholesterol deposits. Ischemic heart disease is the underlying disorder for sudden episodes such as heart attack and sudden death as well as the chronic condition of angina pectoris. Ischemic heart disease is also called coronary artery disease or coronary heart disease."

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You have to be diagnosed with heart duisease by either Echocardiogram or Cardiac Catherization.

A good medicine that would help would be a prescription of IMDUR or Isosorbide Mononitrate which is actually a very slow acting Nitro pill.

J

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calton asked:

So what is the requirement for a VA Disablity Rating for Ischemic Heart Disease

Hopefully it will be under the same DC code for atherosclerotic heart disease-

no one knows yet-the regs are not out yet in the Federal Register-vets can comment publically when it gets there-

tinker -the PAD could be rated as a PN rating for your leg- it is hard for me to say-

I think vets should claim the Ischemic heart disease with all secondary involvements-to include PAD.

This way it is all covered- then again

We have no actual regs yet for how the VA will use the Schedule of Ratings on IHD.

What stands now under CAD ratings is probably what they will use.

Hard top know.

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You have to be diagnosed with heart duisease by either Echocardiogram or Cardiac Catherization.

A good medicine that would help would be a prescription of IMDUR or Isosorbide Mononitrate which is actually a very slow acting Nitro pill.

J

Just a few of my heart meds include isoorbide mononitrate 180mg per day,verapamil 120mg per day, plavix 75mg per day which my cardiologist wants me to take as long as i live, and renexa 500 mg per day which increases the blood flow to the heart muscle, and lisinopril 10mg per day. The VA will only provide plavix for a couple of months unless your cardiologist writes a letter stating you need to be on it indefently or the VA will tell you to just take an aspirin. Doctor sent a letter over 2 months ago and still not on my list of meds from the VA. ;-(

Jeff

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