How do I show Agent Orange presumptive connection for heart disease?

Question

Recently I submitted an agent orange related claim for VA disability for my heart. Diagnosed (with EKG) with mild LVH, a heart cath was done and 50% 2 vessel CAD was diagnosed. Also due to slow heart beat (Sinus bradycardia) resulted in the implantation of a Pacemaker.

Medication is currently being taken for HBP and my heart.

I am currently receiving 10% disability for tinnitus and was curious as to what rating I should expect since my heart condition involves LVH and the pacemaker implantation, etc. thank you for your help.

Jim's Reply

I'm not sure that you'll receive more than a 0% service connected rating. To be eligible for the agent orange presumptive connection you have to show damage to your left ventricle. The left ventricle is the pumping chamber of the heart and the efficiency of the pump can be measured in a number of different ways. If the efficiency is above 50% the pumping chamber is performing normally and the rating for IHD will be 0%. As the efficiency falls below 50%, the corresponding service connected rating would rise. Unless and until we know how well your heart is functioning, we can't say there will be any rating at all for the pacemaker and other problems. The VA will likely say that if your pump function is normal, the slow heart rate is a separate problem not associated with your service. You can find the numbers you're looking for in your medical records or by asking your doctor. You're looking for the Left Ventricular Ejection Fraction or LVEF. The LVEF is measured during catheterization and echocardiogram. The number is expressed as a % and that number tells us how much blood is pumped with each heartbeat. Anything above 50% is a normal finding and VA will rate that at 0%. If you show a number less than 50%, you can claim heart damage that was serious enough to cause a cascade of events leading to the slower heart rate and the need for a pacemaker.

In any case, your next step is to learn that LVEF number and take it from there. If you need some help with this, email me directly.

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