Angina Pectoris (Ischemic Heart Disease)

DC 7005Cardiovascular38 CFR 4.104, DC 7005

Chest pain caused by reduced blood flow to the heart muscle, usually due to narrowed coronary arteries. Ischemic heart disease is a presumptive condition for Agent Orange-exposed veterans. Rated based on exercise capacity and heart function.

Rating Levels

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

Common Pitfalls

⚠Not requesting a stress test or METs estimation — the VA rating depends on documented exercise capacity, and without testing, you may receive a lower rating than warranted.
⚠If you served in Vietnam or were exposed to Agent Orange, ischemic heart disease is a presumptive condition and does not require a nexus letter — make sure your claim references this presumption.
⚠Not documenting ejection fraction through echocardiogram — an EF of 30-50% qualifies for 60% even without a low METs score.
⚠Not filing for secondary conditions like anxiety, depression, or limitations on physical activity that result from living with ischemic heart disease.

Related DBQ Forms

DBQ Heart Conditions
DBQ Ischemic Heart Disease

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Rating Levels

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

Common Pitfalls

⚠Not requesting a stress test or METs estimation — the VA rating depends on documented exercise capacity, and without testing, you may receive a lower rating than warranted.

⚠If you served in Vietnam or were exposed to Agent Orange, ischemic heart disease is a presumptive condition and does not require a nexus letter — make sure your claim references this presumption.

⚠Not documenting ejection fraction through echocardiogram — an EF of 30-50% qualifies for 60% even without a low METs score.

⚠Not filing for secondary conditions like anxiety, depression, or limitations on physical activity that result from living with ischemic heart disease.