Pericardial adhesions is a condition due to the presence of dense fibrous tissue between the parietal and visceral layers of the pericardium sac, which encloses the heart. It is also considered a form of pericarditis in which the layers of pericardium adhere, referred to as adhesive pericarditis.

The cause of the pericardial adhesions may be due to conditions such as pericarditis or trauma.

The patient is usually asymptomatic unless constrictive signs and symptoms such as those found in congestive heart failure (CHF) occur. The signs and symptoms of CHF include: fatigue, heart pain, anxiety, and pale, cool skin. Other signs and symptoms may include: low urine output, cough, dyspnea, rales, orthopnea, swelling of the extremities, distended neck veins, liver engorgement, and elevated central venous pressure. Signs and symptoms of pericarditis may be present (see Diagnostic Code: 7002 Pericarditis).

The functional abilities of cardiac patients can be classified in terms of metabolic equivalents (METs). The classification is generally as follows:

• Light to medium housework is 2 to 4 METs

• Heavy housework or yard work is approximately 5 to 6 METs

• Strenuous activity would be 7 to 10 METs, etc.

To determine the limitations on patient's functional abilities, the METs are considered in accordance with what symptoms are exhibited when the activities are carried out. For example, if a patient is performing activity at the 2 to 4 MET level and experiences dyspnea, fatigue, dizziness or fainting, the patient is considered to have low functional abilities.

Tests may include x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), right-side cardiac catheterization, and electrocardiogram (EKG).

Bed rest, salt restriction, diuretics, or a pericardiectomy may be done in constrictive pericarditis.

Will vary from no residual to a combination of signs and symptoms.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

Notes

• Evaluate cor pulmonale, which is a form of secondary heart disease, as part of the pulmonary condition that causes it.

• One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which breathlessness, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, a medical examiner may estimate the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in those symptoms.

• For this general formula, heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope.

• The rating criteria for cardiovascular conditions underwent full-scale revision effective on November 14, 2021 and January 12, 1999.  A regulatory change was effective August 13, 1998, updated criteria for cold injury residuals under 38 CFR 4.104, DC 7122.  The changes are not considered liberalizing and should not be used as the basis for reduction unless the disability has actually improved.