Hello. I am a 70 yr old guy who has suffered from angina since 1/96. I was a USAF pilot during the Vietnam days. I have undergone 7 heart protocols since 1996 and the only thing determined was that I had a Left Bundle Branch Blockage. Way back then, my Dad a pathologist and VA consultant told me to stay on top of it as a LBBB is a good indicator of heart disease. Finally, in 12/11 I underwent a heart catheterization and they found severe coronary heart disease, and my model heart had a Ramus branch that was 80% blocked. It was too narrow to stint or do angioplasty and it was felt that it was best to treat me medically. They put me on Ranexa. The VA made me 70% disabled with Ischemic Heart Disease. At that time, my cardiologist stated that no other method would have found the blockage, and Echo cardiograms were not accurate in my case. And, in fact, all of my Echos show at last a 60% ejection fraction and all are labeled "Technically Difficult" study. Recently I asked the VA to make me 100% disabled and they once again did an new Echo Cardiogram and it once again showed an good ejection fraction. Now the VA has informed me that I am much better and they are reducing my disability to 10%. I am really confused and wish my Dad was still alive. I don't understand the VA and the reliability of the Echo's as they have never shown my problem and my cardiologist stated the Gold standard was the heart catheterization. Do I have to undergo another heart catheterization to prove my problem? What can I do to convince the VA that I am not better. The drugs make me feel better but the blockage remains. I am looking for an explanation as the VA basis its determination on one of the following: Determination of congestive heart failure- I have not been diagnosed with this; An ECG that shows a fraction less than 60% which is what they are basing it on, or lastly- a MET of 1-3 and that is the category I fit into.
I apparently have good ejection but suffer from angina, dizziness and shortness of breath with any serious effort. So, bottom line is I am trying to understand if Echo's are consistently described as "technically difficult" are they accurate, particularly when a cardiologist has said they are meaningless.