hypertension S4 Gallop Detected Need Insight

[mountain tyme]

Been a long time...but I am still active in helping people God sends into my path...so hear goes...I am helping a fellow vet with a VA claim a few years ago he filed for hypertension..in which the VA declined...after reviewing his Service medical records I did note that his bp was high over the years and that on two occassions they had a 5 day blood pressure check due to the high readings...I also noted that there was no record of a 5 day check in either the notes or labs...the veteran I am helping is retired after 21 years of service...he is serviced connected for cluster headache/migrains/...as I poured over his medical records (inservice) I noted that he had an episode of heart fliberation (sp) back in 90 that required the base to have in taken by air medic to a reginal hospital (civilian) and he was put into the caradiac ICU unit. There were no notes or records from the civialian hospital so I had him send away for those records, which he received last week (how lucky they still had them!) in the records from the hospital it states that he has a high S4 gallop and that the hospital cardic doctor wanted to preform a cardiac catherlization to rule out early cardiomyopathy. As documented in his medial records he agreed to the procedure, that evening he was NPO and the following morning prep. began, for unknown reasons the base hospital decided that the procedure would not be preformend and that he was to do a follow-up with the clinic on base he was discharged that afternoon. In his medical records (service) it has a brief sentance that states" atrial fibrillation-resolved" and states if any further problem occurs to come back.

now fast forward! though out the years this vet has had similar problems like he did back in 94 but he thought that it was nothing and just sat out the dizziness and sweats..until his wife was present durning one of his episodes and brought him to the ER..they put on a 48hr. monitor and it was determined that he needed a pacemaker which he now has.

now the question...since S4 gallop indicated hypertension in which he already filed for and was denied...can he reopen his case with the records from the civilian hospital he just received...and can he also put in for a claim for the pacemaker due to there was never a diagonis back during his service time regarding the 5 days he spent in the ICU...I recommended that he contact his cardiogist and see if he can link the two together...just need some insight on how to guide him.

thanks

mt

[*Bergie*]

Been a long time...but I am still active in helping people God sends into my path...so hear goes...I am helping a fellow vet with a VA claim a few years ago he filed for hypertension..in which the VA declined...after reviewing his Service medical records I did note that his bp was high over the years and that on two occassions they had a 5 day blood pressure check due to the high readings...I also noted that there was no record of a 5 day check in either the notes or labs...the veteran I am helping is retired after 21 years of service...he is serviced connected for cluster headache/migrains/...as I poured over his medical records (inservice) I noted that he had an episode of heart fliberation (sp) back in 90 that required the base to have in taken by air medic to a reginal hospital (civilian) and he was put into the caradiac ICU unit. There were no notes or records from the civialian hospital so I had him send away for those records, which he received last week (how lucky they still had them!) in the records from the hospital it states that he has a high S4 gallop and that the hospital cardic doctor wanted to preform a cardiac catherlization to rule out early cardiomyopathy. As documented in his medial records he agreed to the procedure, that evening he was NPO and the following morning prep. began, for unknown reasons the base hospital decided that the procedure would not be preformend and that he was to do a follow-up with the clinic on base he was discharged that afternoon. In his medical records (service) it has a brief sentance that states" atrial fibrillation-resolved" and states if any further problem occurs to come back.

now fast forward! though out the years this vet has had similar problems like he did back in 94 but he thought that it was nothing and just sat out the dizziness and sweats..until his wife was present durning one of his episodes and brought him to the ER..they put on a 48hr. monitor and it was determined that he needed a pacemaker which he now has.

now the question...since S4 gallop indicated hypertension in which he already filed for and was denied...can he reopen his case with the records from the civilian hospital he just received...and can he also put in for a claim for the pacemaker due to there was never a diagonis back during his service time regarding the 5 days he spent in the ICU...I recommended that he contact his cardiogist and see if he can link the two together...just need some insight on how to guide him.

thanks

mt

What you need to do is request a copy of the c-file, and C&P exam that pertains to the denied claim then proceed from there. What I'd recommend though is that he present the old medical documents from the earlier ICU hospitalization to the cardiologist and ask if the pacemaker that he now has might have been indicated back then, or could the fact that the military dismissed the incident have lead to him now having to have a pacemaker. If the cardiologist can tie the symptoms way back to the pacemaker that he now has he should be able to file for the pacemaker and receive a much higher rating. Also, S4 gallop is not indicative of HTN, it is more an indication of heart failure. Now the heart failure could lead to HTN, but you don't indicate if he has heart failure or the reason for the pacemaker. As I said above he needs the cardiologist to provide a Nexus connecting the incident on active duty to the current condition of having a pacemaker. Personally, I feel that the medical staff who cancelled the catheterization and dismissed his symptoms way back when made a huge mistake, and I believe that contributed to the need for a pacemaker now. Get the Nexus and then file the claim for the pacemaker.

JMO,

Bergie

[stillhere]

I hope he is going to have his check up at a private cardiologist. Then all of this can be looked at he will be able to get a professional opinion.

I do not not trust the VA to police any gov't agency over medical decisions. I have my reasons and they too are heart related and almost killed me. Pay for an outside private evaluation and protect your self!

[mountain tyme]

What you need to do is request a copy of the c-file, and C&P exam that pertains to the denied claim then proceed from there. What I'd recommend though is that he present the old medical documents from the earlier ICU hospitalization to the cardiologist and ask if the pacemaker that he now has might have been indicated back then, or could the fact that the military dismissed the incident have lead to him now having to have a pacemaker. If the cardiologist can tie the symptoms way back to the pacemaker that he now has he should be able to file for the pacemaker and receive a much higher rating. Also, S4 gallop is not indicative of HTN, it is more an indication of heart failure. Now the heart failure could lead to HTN, but you don't indicate if he has heart failure or the reason for the pacemaker. As I said above he needs the cardiologist to provide a Nexus connecting the incident on active duty to the current condition of having a pacemaker. Personally, I feel that the medical staff who cancelled the catheterization and dismissed his symptoms way back when made a huge mistake, and I believe that contributed to the need for a pacemaker now. Get the Nexus and then file the claim for the pacemaker.

JMO,

Bergie

Dear Bergie..thank you for the insight...1st. there was no C/P done, they based the denial for hypertension on his service medical records. After I read the denial decision he has and after looking at this B/P readings it didn't make sense. Luckly for him the denial letter is stamped Jul 30, 2008 so first thing on wed. I am taking him up to the State Va officer and have him put in a Notice of Disagreement...tomorrow he is bringing a copy of his service medical records along with the civilian hosp. records to his Cardio doctor who had the pacemaker implanted. his nurse told him to drop them off. I hope he can provide the Nexus connecting the incident of active duty to his present condition or at least tie in the hypertension. Also by all indications of letters he had from buddies back in the 80's he sored loudly...after he retired he was diagnosied with sleep apena..so maybe the doctor can tie that in...I feel the same way you do in regards to the AF denying him that test. What The doctor wrote in him medical record is this...

"In view of this new onset of chest pain and accompanying atrial fibrillation and J point adnormality on the exercise treadmill, cardiac catheterization was highly recommended for futher assessement of early cardiomyopathy. This will be done on an elective basis at an Air Force Base Hospital. The results of the above-mentioned tests and the recommendation for cardiac catherization were discussed with Dr. xxxxx at xxxxx Afb Hospital.

The patient is discharged on no medications and will see Dr. xxxx for follow-up tomorrow."

needless to say when the vet went in for his follow up appointment and discussed the test the doctor did not feel it was warrented...now get this..his B/P and pulse taken on that day was...

10 May 1988 90/58 pulse 60... Go figure!!!...what were they thinking...hummm could it be the project he was working on was in the black and the need for him was greater then his life...

I really hope his cardio doctor can pull it together for him...please keep him in your prayers this like all vets s/he really deserves a break..

thanks again

mt

[mountain tyme]

I hope he is going to have his check up at a private cardiologist. Then all of this can be looked at he will be able to get a professional opinion.

I do not not trust the VA to police any gov't agency over medical decisions. I have my reasons and they too are heart related and almost killed me. Pay for an outside private evaluation and protect your self!

Good evening still here...

thank you for the insight...I am also of the same thought...after I went though the wringer with the VA on my claim..I have a real sence of distrust as well when it comes to the way the VA rates claims...but I also know that there are some really good people up there as well...so I am praying that God delivers these papers to the right hand...like the way He lead this Vet into my path...hopefully with the help of this board and google...we can get this vet a fair shake...

I will update as we go along...

God Speed

mt