I have just started an original AO claim for Ischemic Heart
Disease and am not at all sure what I should be doing so I will try to lay out
the bare bones of it. (I apologize if I am overloading you with 411)
1965 USMC Chu Lai (Definitely boots on the ground and I have my original DD214)
1980 Started on cholesterol meds
1992 momentarily collapsed during lunch on a work day. Terminated following Tuesday before returning to work and while being treated/ diagnosed by another division of the company; CIGNA. Pretty extensive work up but cause was never established. Blamed on panic attacks.
1994 Angiogram 50% obstruction. No Angioplasty. Started on aspiring therapy, blood pressure, and vasodilator meds. Remained on these with adjustments and the later addition of med to depress heart rate.
1996 Abnormal Treadmill followed by stress echo. Cath Lab was recommended. I asked for further testing if possible to see if Angio was really necessary. Stress Echo no need for angio.
1967 Same as 1996.
1998 PCP (primary care physician) skipped Treadmills for a few years and sent me straight to cardio for stress echoes as part of annual physical.
2001 Episode on freeway with rapidly narrowing vision and near collapse resulted in transport to ER, discharged w/o Dx and eventual stress treadmill. No Dx for episode.
2005 Episode in gas station parking lot in mid morning. Attendant observed that I walked like a crab and called paramedics. Declined transport to ER and went to my doctor. Standard cardio work up and carotid ultra but found no explanation.
2008 Treadmill done in-house by PCP Group. Cardiologist attending to familiarize with PCP's procedures thought he heard a Murmur. Internist conducting test said he didn't hear one. May not be reflected in chart.
2010 Treadmill performed, due to complaints of chest discomfort indicated changes. Follow up nuclear imaging indicated mild ischemia. Angiography indicates 70-75% occlusion on one artery and 50% of two others. Stent inserted via angioplasty to open the greater occlusion which I believe was at the top of the so called widow maker.
Follow up treadmill was much better and I felt much better, but energy has deteriorated.
End of 2010 Went to PCP group to some light headedness, trouble speaking, and mild balance problems. Strip EKG done and referred to ER to rule out TIAs. After MRI showed negative I discharged myself against medical advice. Saw my cardio who did another nuclear imaging study and saw nothing to indicate cath lab.
11/2011 PCP increased BP med for the first time. 10 mg to 20 mg of Lisinopril.
12/2011 BP having gone higher, now 170 (I think it was that high for a while and it was be taken with poor techique, it was increased to 40 mg.
1/2012 BP 160/70 and HR 60. Hour post medication. Still too high. PCP checks ankles for swelling, which is minimal, adds a diuretic. He said he cannot increase my other meds, including one that holds my HR down.
I believed that my last nuclear imaging, which was over a year post stent, had a LVEF of 62%. I don't know my METs.
I have listed the PCP and the treating cardiologist on my application. VA is getting info from the Cardio per its letter. It does not say that it is getting records from the PCP.
Forgive me it I gave you way too much info. I am wondering:
A. Will I get a low rating for IHD if there is less due to the stent I got in 2010.
B. Should I be doing anything such as:
1. copying all of my records and supplying the VA with any that it may overlook or simply not request?
2. Retain a doctor to provide me with a confidential record review and opinion?
3. Have my Medical Examiner send his opinion to the VA before it renders its rating?
4. Anything else?
Thanks in advance.