Ischemic Heart Disease

[GuaymasJim]

Before I begin, I want to admit that these are probably dumb questions. As a geek, I have spent many many hours trying to research and understand, but I just must be dense because I haven’t met with any success.

Here goes:

A medication which I receive from the VAMC for the service-connected condition that underlies my 34 year-old TDUI P&T VA rating and SSDI determination is known to cause some patients to experience Myocardial Ischemia. During the past several months, I have been experiencing a severe pain that feels like someone has reached under my ribcage grabbed my heart and is squeezing so hard that it feels like my heart is about burst open. Accompanying this pain is a burning sensation under my ribcage along a line starting just above my right nipple and extending to my left armpit.

The two pains can and do occur separately. The “heart pain” can happen anytime including when I am asleep and usually lasts for several hours. The “burning pain” sometimes last for days. If I use the VA medication as directed, the “heart pain” starts within about 10 minutes and lasts longer and is much more intense than when it happens without the medication. During the “heart pain” without having used the medication my blood pressure rises dramatically 140-150/85-90; and with the medication my BP goes off the charts into the very dangerous zone (155-161/102-110). In the absence of both the medication and the pain my normal BP is 90-100/65-75.

Two recent ECGs show “possible atrial enlargement.” All prior ECGs (ten years worth) are normal.

Here is where my confusion begins: Is myocardial ischemia just one type of Ischemic Heart Disease (IHD), or is it a separate condition? If it is IHD (I believe it is but am not sure) how would I claim it? IHD is an Agent Orange presumptive (have confirmed stressors and combat decorations) and damage done by VA medications can be the basis of a valid claim.

I would appreciate any input!

[Chuck75]

As a Vietnam (feet on ground) vet with IHD, and a fight with the VA between 2005 and 2011. (Until the Nehmer review board awarded just about everything the VARO had previously denied). - - -

A board certified interventional cardiologist's written diagnosis of IHD, preferably using the VA's new forms, and including lab test results, is your best evidence. A heart cath with estimates of LVEF more or less is proof positive of IHD.

If you are a Vietnam Vet with combat awards, these can substantiate your Vietnam service. They can be personal or even unit awards. A "CAR" (CR), or other awards that cite combat "conditions" are considered "combat awards", along with others, such as a bronze or silver star. If you were hospitalized in a VAMC, and the records show IHD related problems, You may be entitled to an earlier award date than the date of your "formal" claim".

You also should, assuming you can get a doctor's written opinion on it, also claim "caused or at least aggravated by" the medicines you mention, assuming that they are for an already service connected condition.

Edited June 28, 2012 by Chuck75

[GuaymasJim]

Seems like we are a bunch of night owls.

All I can say is thanks! The information is exactly what I needed. I am taking the problem very seriously as a couple of the worst episodes made me believe that the jig was up.