Myocardial infarction — VA Diagnostic Code 7006

The Diseases of the Heart caption carries this headnote: “[Unless otherwise directed, use this general rating formula to evaluate diseases of the heart.]” The brackets are in the headnote.

Note (1): Evaluate cor pulmonale, which is a form of secondary heart disease, as part of the pulmonary condition that causes it.

Note (2): One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which breathlessness, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, a medical examiner may estimate the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in those symptoms.

Note (3): For this general formula, heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope.

DC 7006 prints a three-month 100 percent line and a thereafter sentence. This page does not say the form replaces either sentence.

Section 3.309(e) lists “Ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal's angina).” Note 2 says that term does not include hypertension or peripheral manifestations of arteriosclerosis such as peripheral vascular disease or stroke, or any other condition that does not qualify within the generally accepted medical definition of Ischemic heart disease. The research row for ischemic heart disease points at DC 7005. This page does not move that row to DC 7006.

Section 3.309(c)(1) lists “Atherosclerotic heart disease or hypertensive vascular disease (including hypertensive heart disease) and their complications (including myocardial infarction, congestive heart failure, arrhythmia).” That sentence does not print DC 7006. It is a former-prisoner-of-war listing. Paragraph (c)(2) is the 30-day internment list. Myocardial infarction is in paragraph (c)(1).

A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.