Coronary artery disease and related ischemic heart disease are rated on measured cardiac function, primarily your workload capacity in METs (metabolic equivalents) from stress testing, or your left ventricular ejection fraction from an echocardiogram, whichever produces the higher rating.
METs and ejection fraction are alternative paths to the same rating tier, you don't need both, and the VA is supposed to use whichever measurement is more favorable to you. If lab exercise testing can't safely be performed, an examiner's estimate of your METs level (supported by concrete examples like slow stair climbing) can be used instead.
| Rating | Criteria |
|---|---|
| 100% | Chronic congestive heart failure, or workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or left ventricular ejection fraction less than 30% |
| 60% | More than one episode of acute congestive heart failure in the past year, or workload greater than 3 but not greater than 5 METs results in symptoms, or ejection fraction of 30–50% |
| 30% | Workload greater than 5 but not greater than 7 METs results in symptoms, or evidence of cardiac hypertrophy or dilatation on ECG, echocardiogram, or X-ray |
| 10% | Workload greater than 7 METs results in symptoms, or continuous medication is required |