Va Form 21-0960a-4 - Heart Conditions (Including Ischemic And Non-Ischemic Heart Disease, Arrhythmias, Valvular Disease And Cardiac Surgery) Disability Benefits Questionnaire Page 5

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SECTION XIII - DIAGNOSTIC TESTING

NOTE: For VA purposes, exams for all heart conditions require a determination of whether or not cardiac hypertrophy or dilatation is present. The suggested order of

testing for cardiac hypertrophy/dilatation is EKG, then chest x-ray (PA and lateral), then echocardiogram. An echocardiogram to determine heart size is only necessary

if the other two tests are negative. Also for VA purposes, if LVEF testing is not of record, but available medical information sufficiently reflects the severity of the

veteran's cardiovascular condition, LVEF testing is not required.

13A. IS THERE EVIDENCE OF CARDIAC HYPERTROPHY?

YES

(If "Yes," indicate how this condition was documented):

EKG

Chest x-ray

Echocardiogram

Date of test:

13B. IS THERE EVIDENCE OF CARDIAC DILATATION?

YES

(If "Yes," indicate how this condition was documented):

Chest x-ray