Takotsubo Cardiomyopathy (Stress Cardiomyopathy)

DC 7020Cardiovascular38 CFR 4.104, DC 7020

A temporary weakening of the heart muscle triggered by severe emotional or physical stress, sometimes called broken heart syndrome. The left ventricle balloons out and does not pump well. The VA rates takotsubo cardiomyopathy based on your heart workload capacity measured in METs, ejection fraction, and whether you have congestive heart failure.

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 7020

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.104, DC 7020. 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 causing symptoms, or your 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%
Severe exercise limitation
Ongoing heart failure management

Common Pitfalls

⚠Assuming takotsubo always fully resolves — while many veterans recover, some develop chronic heart failure or recurrent episodes. Document any lasting cardiac symptoms even after the initial event.
⚠Not getting follow-up echocardiograms to show persistent wall motion abnormalities or reduced ejection fraction — these findings support a higher rating.
⚠Not connecting the triggering stressor to military service — combat stress, military sexual trauma, or intense training can all trigger takotsubo and should be documented in a nexus opinion.
⚠Not reporting ongoing symptoms like chest pain, exercise intolerance, and fatigue during C&P exams — many veterans downplay residual symptoms after the acute event.

Related DBQ Forms

DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Takotsubo Cardiomyopathy (Stress Cardiomyopathy)

How the VA rates this condition

Diagnostic code

DC 7020

Rating range

10% – 100%

Rating levels

Rating Levels

You have chronic congestive heart failure, or your workload capacity is 3 METs or less causing symptoms, or your 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%
Severe exercise limitation
Ongoing heart failure management

Common Pitfalls

⚠Assuming takotsubo always fully resolves — while many veterans recover, some develop chronic heart failure or recurrent episodes. Document any lasting cardiac symptoms even after the initial event.

⚠Not getting follow-up echocardiograms to show persistent wall motion abnormalities or reduced ejection fraction — these findings support a higher rating.

⚠Not connecting the triggering stressor to military service — combat stress, military sexual trauma, or intense training can all trigger takotsubo and should be documented in a nexus opinion.

⚠Not reporting ongoing symptoms like chest pain, exercise intolerance, and fatigue during C&P exams — many veterans downplay residual symptoms after the acute event.