However, a separate evaluation for hypertension may be awarded when the sole renal disability is the absence of a kidney, or the requirement of regular dialysis. Notes: The cause of hypertension is unknown in the vast majority of cases. Do not establish SC for hypertension if the evidence does not contain blood pressure readings as specified in , Note 1. For more information on hypertension and nephritis, see . Reference: Chronic rheumatic heart disease results from single or repeated attacks of r. Effects of Rheumatic rheumatic fever that produce valvular disease, manifested by Heart Disease rigidity and deformity of the cusps fusion of the commissures, or shortening and fusion of the chordae tendineae. The earliest evidence of organic valvular disease is a significant murmur, and hemodynamically significant valvular lesions found on x-ray, fluoroscopy, and ECG study, since these reveal the earliest stages of specific chamber enlargement. SC for an aortic valve insufficiency that manifests without other Note: cause after an in-service case of rheumatic fever. s. Evaluating Accepted medical principles do concede an etiological relationship not Rheumatic between rheumatic heart disease and either hypertensive or arteriosclerotic Heart Disease heart disease. Therefore, do extend secondary SC to systemic not Coexisting manifestations or arteriosclerosis in areas remote from the heart if the Veteran With is SC for rheumatic heart disease. Hypertensive or Arteriosclerotic If a Veteran who is SC for rheumatic heart disease develops hypertensive or Heart Disease arteriosclerotic heart disease after the applicable presumptive period following military discharge, request a medical opinion to determine which condition is causing the current signs and symptoms. If the examiner is unable to separate the effects of one type of heart Note: disease from another, the effects must be rated together. Grant SC on a secondary basis for the following conditions that develop t. Considering Cardiovascular subsequent to the SC amputation of one lower extremity at or above the knee, Conditions or SC amputations of both lower extremities at or above the ankles:
However, a separate evaluation for hypertension may be awarded when the sole renal disability is the absence of a kidney, or the requirement of regular dialysis. Notes: The cause of hypertension is unknown in the vast majority of cases. Do not establish SC for hypertension if the evidence does not contain blood pressure readings as specified in , Note 1. Reference: For more information on hypertension and nephritis, see . r. Effects of Rheumatic Heart Disease Chronic rheumatic heart disease results from single or repeated attacks of rheumatic fever that produce valvular disease, manifested by rigidity and deformity of the cusps fusion of the commissures, or shortening and fusion of the chordae tendineae. The earliest evidence of organic valvular disease is a significant murmur, and hemodynamically significant valvular lesions found on x-ray, fluoroscopy, and ECG study, since these reveal the earliest stages of specific chamber enlargement. Note: SC for an aortic valve insufficiency that manifests without other cause after an in-service case of rheumatic fever. s. Evaluating Rheumatic Heart Disease Coexisting With Hypertensive or Arteriosclerotic Heart Disease Accepted medical principles do not concede an etiological relationship between rheumatic heart disease and either hypertensive or arteriosclerotic heart disease. Therefore, do not extend secondary SC to systemic manifestations or arteriosclerosis in areas remote from the heart if the Veteran is SC for rheumatic heart disease. If a Veteran who is SC for rheumatic heart disease develops hypertensive or arteriosclerotic heart disease after the applicable presumptive period following military discharge, request a medical opinion to determine which condition is causing the current signs and symptoms. Note: If the examiner is unable to separate the effects of one type of heart disease from another, the effects must be rated together. t. Considering Cardiovascular Conditions Grant SC on a secondary basis for the following conditions that develop subsequent to the SC amputation of one lower extremity at or above the knee, or SC amputations of both lower extremities at or above the ankles:
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