Evidence Checklist: Angina Pectoris (Ischemic Heart Disease)

Exercise stress test with METs at anginal thresholdCritical

Stress test documenting the METs at which chest pain or ischemic changes occur. METs at onset of angina drives the rating: 3 or less = 100%, 3-5 = 60%, 5-7 = 30%, over 7 = 10%.

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.

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.

Cardiac catheterization report documenting CAD

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

Cardiology records with NYHA and CCS classification

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

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.

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.

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.

Completed DBQ Heart Conditions (Ischemic Heart Disease)Critical

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

Service treatment records (STRs)Critical

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