Syphilitic Heart Disease

DC 7004Cardiovascular38 CFR 4.104, DC 7004

Heart damage caused by tertiary syphilis infection, typically affecting the aorta and aortic valve. This can cause aortic regurgitation, aortic aneurysm, and coronary ostial stenosis. The VA rates syphilitic heart disease based on workload capacity in METs, congestive heart failure, and ejection fraction.

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 7004

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.104, DC 7004. 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

You have chronic congestive heart failure, or your workload capacity is 3 METs or less with symptoms, or your left ventricular ejection fraction is less than 30 percent.

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Aortic aneurysm requiring surgical repair
Severe aortic regurgitation

Common Pitfalls

⚠Not documenting the causal link between syphilis and heart damage — service treatment records showing syphilis diagnosis in service are essential. Late-stage cardiovascular effects may appear decades after initial infection.
⚠Not obtaining an echocardiogram focused on the aortic valve and root — syphilitic heart disease characteristically affects the ascending aorta and aortic valve, so targeted imaging is critical.
⚠Not filing for secondary conditions — aortic regurgitation from syphilis can cause secondary hypertension, heart failure, and arrhythmias, each potentially ratable.
⚠Not requesting aortic CT angiography if aneurysm is suspected — aortic aneurysm is a serious complication that may warrant a separate or higher rating.

Related DBQ Forms

DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Syphilitic Heart Disease

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 7004

Rating range

10% – 100%

Rating levels

Rating Levels

You have chronic congestive heart failure, or your workload capacity is 3 METs or less with symptoms, or your left ventricular ejection fraction is less than 30 percent.

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Aortic aneurysm requiring surgical repair
Severe aortic regurgitation

Common Pitfalls

⚠Not documenting the causal link between syphilis and heart damage — service treatment records showing syphilis diagnosis in service are essential. Late-stage cardiovascular effects may appear decades after initial infection.

⚠Not obtaining an echocardiogram focused on the aortic valve and root — syphilitic heart disease characteristically affects the ascending aorta and aortic valve, so targeted imaging is critical.

⚠Not filing for secondary conditions — aortic regurgitation from syphilis can cause secondary hypertension, heart failure, and arrhythmias, each potentially ratable.

⚠Not requesting aortic CT angiography if aneurysm is suspected — aortic aneurysm is a serious complication that may warrant a separate or higher rating.