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Evidence checklist

Angina Pectoris (Ischemic Heart Disease)

DC 700538 CFR § 4.104Cardiovascular

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 4 collected
Exercise stress test with METs at anginal thresholdCritical

Stress test documenting the METs at which chest pain or ischemic changes occur. Angina is one of the heart failure symptoms § 4.104 Note (3) lists, so the METs level at which it appears drives the rating: 3.0 METs or less = 100%, 3.1-5.0 METs = 60%, 5.1-7.0 METs = 30%, and 7.1-10.0 METs (or continuous medication required for control) = 10%.

Private provider · independent opinion
Nuclear stress test or cardiac PET showing perfusion defectCritical

Nuclear myocardial perfusion imaging documenting inducible ischemia location, extent, and severity — objective evidence of anginal substrate.

Private provider · independent opinion
Nexus opinion linking angina to service or Agent Orange presumptiveCritical

A medical opinion connecting ischemic heart disease to service. Angina pectoris caused by ischemic heart disease is a presumptive condition for veterans with Agent Orange / herbicide exposure.

Private provider · independent opinion
Cardiac catheterization report documenting CAD

Coronary angiography report documenting percent stenosis in coronary arteries, number of vessels diseased, and any prior interventions.

Private provider · independent opinion
02

Treatment records

0 of 1 collected
Cardiology records with NYHA and CCS classification

Cardiology notes documenting Canadian Cardiovascular Society (CCS) angina class and symptom progression.

VA or private records · written request
03

Lay statements

0 of 3 collected
Anginal episode log (frequency, duration, nitroglycerin use)

Personal log documenting chest pain episodes: frequency, duration, precipitating activities, and need for nitroglycerin use. Unstable angina at rest supports higher ratings.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Heart Conditions (Ischemic Heart Disease)Critical

Standardized form capturing stress test results, METs, ejection fraction, and functional limitations from angina pectoris.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forBuddy statement builderGuided VA Form 21-10210

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