Prinzmetal / Vasospastic Angina

DC 7005Cardiovascular38 CFR 4.104, DC 7005

A type of chest pain caused by temporary spasms in the coronary arteries that reduce blood flow to the heart. Unlike typical angina, it often happens at rest, especially at night. The VA rates it based on how often episodes occur, METs capacity, and whether coronary artery spasm has been documented.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 7005

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.104, DC 7005. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your vasospastic angina causes chronic severe limitation. Your workload capacity is 3 METs or less, you have chronic congestive heart failure, or your ejection fraction is less than 30 percent from repeated coronary artery spasm damage.

What the VA looks for

Workload capacity of 3 METs or less
Chronic congestive heart failure from spasm-induced ischemia
Left ventricular ejection fraction less than 30%
Refractory vasospasm despite maximum medical therapy
Recurrent hospitalizations for severe angina episodes

Common Pitfalls

⚠Not getting a provocation test (ergonovine or acetylcholine challenge) to document coronary artery spasm — standard angiography may appear normal between episodes. This test is the key to proving your diagnosis.
⚠Not keeping a detailed symptom diary of angina episodes — document the date, time, duration, triggers, and severity of each episode. This frequency data directly affects your rating.
⚠Not requesting Holter monitoring to capture ST-segment changes during episodes — transient ECG changes during vasospasm episodes provide strong objective evidence.
⚠Not differentiating Prinzmetal angina from typical angina in your medical records — the treatment and prognosis differ, and the VA examiner needs to understand the vasospastic mechanism.

Related DBQ Forms

DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Prinzmetal / Vasospastic Angina

How the VA rates this condition

Diagnostic code

DC 7005

Rating range

10% – 100%

Rating levels

Rating Levels

What the VA looks for

Workload capacity of 3 METs or less
Chronic congestive heart failure from spasm-induced ischemia
Left ventricular ejection fraction less than 30%
Refractory vasospasm despite maximum medical therapy
Recurrent hospitalizations for severe angina episodes

Common Pitfalls

⚠Not getting a provocation test (ergonovine or acetylcholine challenge) to document coronary artery spasm — standard angiography may appear normal between episodes. This test is the key to proving your diagnosis.

⚠Not keeping a detailed symptom diary of angina episodes — document the date, time, duration, triggers, and severity of each episode. This frequency data directly affects your rating.

⚠Not requesting Holter monitoring to capture ST-segment changes during episodes — transient ECG changes during vasospasm episodes provide strong objective evidence.

⚠Not differentiating Prinzmetal angina from typical angina in your medical records — the treatment and prognosis differ, and the VA examiner needs to understand the vasospastic mechanism.