The following notes came from my Va file AUG 08. The points heighted in red are problem areas for me and I have included my opinion related to those points. I wanted to type the complete finds, because I think it's tricky in some parts when reading.
12 Service connection for paroxysmal atrial fibrillation (claimed as atrial fibrillation; chest pains).
Your veteren's application for compensation and/ or pension received August , 2007, requested service connection for atrial fibrillation and for chest pains. Service treatment records were reviewed. Your enlistment examination did not show any findings of pre-existing heart condition In August 1995; you had complaints of chest pains after lifting weights. No cardiac disability was diagnosed at the time, and you instead diagnosed with a muscle strain with possible transient nerve compression.
In September 2002, you were hospitalized for an episode of atrial fibrillation. The condition corrected while you were in the hospital, and the follow-up report shows "suspect lone atrial fibrillation maybe related to GNC products." However, a treatment report from February 2003 shows that you had five recurrence of atrial fibrillation following the incident in September 2002. The diagnose of the condition was changed to paroxysmal atrial fibrillation. You were placed on medication to help control your heart rate. ( I am still on these medication today.) You also reported atypical chest pains in February 2003, but these were determined to be non-cardiac in origin. A clinical from September 2003 shows that you had been evaluated by cardiology specialist, and were determined to have no structural defects of the heart. No clear origin of the atril fibrillation was discovered. A follow-up visit in February 2004 re-instated the diagnosis of lone atrial fibrillation, based on no recurrence since February of the previous year. Because you indicated some recurrence of palpitation in March 2004, you were continued on Lopressor and given a portiable monitor to wear for documentation of episodes. A treatment report from November 2004 shows complaints of chest pain with tingling and numbness of the left arm. In April 2006, you were again seen for complaints of chest pains, which were atypical and again considered to be likely non-cardiac in origin. The history of atrial fibrillation was review, and you were noted to have normal sinus rhythm, with symptoms apparently controlled on Flecainide and Lopressor. Your February 2007 separation examination shows that you were still on medication for atril fibrillation, and had EKG findings of minimal voltage for left ventricular hypertrophy vs. normal variant. In March 2007, you reported to the emergency room with complaints of rapid hearteat after you forgot to take your Lopressor mediation. Following treatment with medication, the atrial fibrillation resolved. Your medication regimen was changed from Lopressor and Tambocor to sotalol to better control the artial fibrillation
My comments relating to this matter. I went to the emergency room at Fort X, I was admitted to that hospital then transfer to another hospital out base that could provide the care I needed. In the notes from VA it doesn't state this I was in the hospital for 3-4 days after reporting to the emergency room. If you read what they have it seems like I was given some more medicine and allowed to leave that same day not true.
A letter requesting any further evidence for issues claimed on your initial application was sent to you dated August 22, 2007. The medical records from Doctor's Cardiology clinic show diagnosis of paroxysmal atrial fibrillation in March 2007, with new medication prescribed for this condition. An echocardiogram in June 2007 shows findings of normal left ventricular function without hypertrophy, mild to moderate mitral regurgitation, and mild tricuspid regurgitation. The diagnosis of paroxysmal artial fibrillation was confirmed. This diagnosis was also shown during the most recent visit to Doctor's Cardiology Clinic in January 2008, though you reported no palpitations since cardioversion ( the date of cardioversion was not indicated). I am not sure what this means
BJ Army Community Hospital records from May 2007 show diagnosed arterial fibrillation on continuing medication for control. The private medical report from xxx- xxx Cardiology, dated September, 2007, shows findings of normal sinus rhythum and rate on the EKG, but confirmed a diagnosis of paroxysmal arterial fibrillation based on history.
The VA examination dated Septmber ,2007, was reviewed. You reported having episodes or rapid heart rate, and being told you had a transient arrhythmia. You indicated that you had not had any fast heart rates during the past year. You have had no episodes of myocardial infarction, stoke, o congestive heart failure. You did not report any recent episodes of chest pains. Your estimated METs level was 9. The examiner indicated that EKG stress testing was not recommended due to painful knees. You currently take two medications for you arrhythmia condition. Physical inspection found normal heart rate and rhythm, with no murmus, clicks, rubs, or extra sounds. The examiner reported normal findings on echocardiogram. You were diagnosed with paroxysmal atrial fibrillation under treatment.
My problem with this paragraph is that I couldn't have said I have had no problems with my heart over the past year, because records show I was hospitalized in March of this same year so where did this statement come the examiner stated, I am not sure. There were copies of my hospital charts in my medical file during this exam.
The VA examination dated November, 2007, found regular and rhythm, with no murmur. The examiner indicated a Class I heart disease. The examiner indicted that you were not on current treatment for this condition, and were reportly not no continuous medication. You denied a history of syncope, fatigue, angina, dizziness, and dyspnea. Chest X rays were normal, and echocacardiogram was essentially normal, with trace mitral regurgitation. The examiner diagnosed no evidence of arrhythmias or heart condition.
My issue with this paragraph, is that I was under care for this condition at that time and was taking and still take medication for this condition. I reported to sick call a few times before I was release from active duty for fatigue I will find those charts to include in my response back to the VA. Over the past eight years I was hospitalized at less five time for this condition, so for them to say it don't exist is false.
Sevice connection for paroxysmal atrial fibrillation ( claimed as atrial fibrillation; chest pains) has been established as directly related to military service. Service treatment records show recurrences of rapid heart rate diagnosed as paroxysmal atrial fibrillation, which required continuous medication. Though the most recent VA examination indicated "no continuous medication" private medical records show prescribed medication continued though 2007-2008 for diagnosis of paroxysmal atrial fibrillation, and the September 2007 VA examination also confirmed this diagnosis.
A noncompensable evaluation is assigned from August, 2007 the day after your release from active duty. A noncompensable evaluation is assigned unless there is permanent atrial fibrillation ( lone atrial fibrillation); or one to four episodes per year for AFIB or other supraventricular tachycardia documented by ECC or holter monitor. The evidence of record shows continuing diagnosis of paroxyamal atrial fibrillation and use of medication to contol this condition, but does not show EGG or holter monitor documentation of 1-4 episodes per year. The most recent medical records show no episodes since cardioversion, with your last reported subjective complaints shown in March 2007.
I had one episode that year of the CP exam please clear up thanks for your time.