Cardiovascular Overview

The cardiovascular system is composed of the heart and blood vessels (arteries, veins, and capillaries), and has the overall responsibility of supplying body cells with oxygen and nutrients. The heart provides the pumping force, which effects the circulation of blood throughout the vascular system. Normally, the cardiovascular system is able to adapt and adjust to the demands of the body by increasing the cardiac reserve when needed. The heart beats over 104,000 times daily and pumps about 8,193 liters of blood through more than 60,000 miles of blood vessels. The arteries take blood to body tissues and veins bring the blood back to the heart to be sent to the lungs before it is returned to the tissues. Systole is the term used for the contraction of the heart chambers, and diastole is the term for the relaxation phase.

The heart is a four-chambered, muscular organ positioned in the center of the chest between the lungs. The heart is hollow, pear shaped, and connected to the breastbone by ligaments. The four chambers consist of two atria and two ventricles. The right and left atria make up the upper chambers, and the right and left ventricles make up the lower chambers. The left atrium and left ventricle are interconnected by an atrio-ventricular valve, the bicuspid valve, or mitral valve. The right atrium and right ventricle are interconnected by an atrio-ventricular valve, the tricuspid valve. A septum separates the right and left sides of the heart.

The heart tissue consists of three layers: the epicardium, the outer, thin layer; the myocardium, the middle, muscular layer; and the endocardium, the inner lining. The pericardium, a fibrous sac surrounding and enclosing the heart, serves to protect the heart.

Arteries, veins and capillaries are the major constituents of the vascular system forming passageways for the circulation of blood. Small arteries are called arterioles, and small veins are called venules. Blood circulates from the heart into arteries, arterioles, capillaries, venules, veins and back to the heart. Capillaries provide sites for the exchange of nutrients and end products of metabolism.

Diseases of the Heart

General Considerations for Rating

  • Cor pulmonale.

    Evaluate cor pulmonale, which is a form of secondary heart disease, as part of the pulmonary condition that causes it. (38 CFR 4.104 [Schedule of ratings-cardiovascular])

  • Metabolic equivalents.

    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 dyspnea, 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, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used. (38 CFR 4.104 [Schedule of ratings-cardiovascular])

  • Congenital heart defect.

    The term covers common heart conditions due to prenatal influences, such as patent foramen ovale, patent ductus arteriosus, coarctation of the aorta, intraventricular septal defect, and other congenital conditions.

Problematic Issues

  • Claudication

  • Cold Injury

  • Hypertensive Vascular Disease

  • Peripheral Vascular Disease

  • Risk Factors of Coronary Artery Disease

Heart Diseases

Diagnostic Code Name VA Exam Acronym
7000 Valvular heart disease (including rheumatic heart disease) Heart VHD
7001 Endocarditis Heart ---
7002 Pericarditis Heart ---
7003 Pericardial adhesions Heart ---
7004 Syphilitic heart disease Heart ---
7005 Arteriosclerotic heart disease (Coronary artery disease) Heart CAD
7006 Myocardial infarction Heart MI
7007 Hypertensive heart disease Heart HCVD
7008 Hyperthyroid heart disease Heart ---
7009 Bradycardia (Bradyarrhythmia), symptomatic, requiring permanent pacemaker implantation Heart
7010 Supraventricular arrhythmias Arrhythmias SVA
7011 Ventricular arrhythmias (sustained) Arrhythmias ---
7015 Atrioventricular block Arrhythmias AV Block
7016 Heart valve replacement (prosthesis) Heart ---
7017 Coronary bypass surgery Heart CABG
7018 Implantable cardiac pacemakers Arrhythmias ---
7019 Cardiac transplantation Heart ---
7020 Cardiomyopathy Heart ---

Artery & Vein Diseases

Diagnostic Code Name VA Exam Acronym
7101 Hypertensive vascular disease (hypertension and isolated systolic hypertension) Hypertension HCVD
7110 Aortic aneurysm Arteries, Veins & Misc. ---
7111 Aneurysm, any large artery Arteries, Veins & Misc. ---
7112 Aneurysm, any small artery Arteries, Veins & Misc. ---
7113 Arteriovenous fistula, traumatic Arteries, Veins & Misc. AVF
7114 Arteriosclerosis obliterans Arteries, Veins & Misc. ASO
7115 Thromboangiitis obliterans (Buerger's disease) Arteries, Veins & Misc. TAO
7117 Raynaud's syndrome Arteries, Veins & Misc. ---
7118 Angioneurotic edema Arteries, Veins & Misc. ---
7119 Erythromelalgia Arteries, Veins & Misc. ETHA
7120 Varicose veins Arteries, Veins & Misc. VV
7121 Post-phlebitis syndrome of any etiology Arteries, Veins & Misc. VV
7122 Cold injury residuals Cold injury protocol ---
7123 Soft tissue sarcoma (of vascular origin) Arteries, Veins & Misc. ---