Ischaemic Heart Disease G006
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25
Factors in CCPS as at 27 April 2010 (G006)
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/alphabetic-index-statements-principles/h-l/ischaemic-heart-disease-g006/factors-ccps-27-april-2010-g006
A category 1A stressor
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/category-1a-stressor
A category 1B stressor
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/category-1b-stressor
A drug from the specified list
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/drug-specified-list
Acute cholinergic poisoning from exposure to an organophosphorus ester
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/acute-cholinergic-poisoning-exposure-organophosphorus-ester
Chronic renal disease
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/chronic-renal-disease
Cigar smoking
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/cigar-smoking
Cigarette smoking
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/cigarette-smoking
Clinically significant anxiety spectrum disorder
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/clinically-significant-anxiety-spectrum-disorder
Clinically significant depressive disorder
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/clinically-significant-depressive-disorder
Combined oral contraceptive pill
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/combined-oral-contraceptive-pill
Diabetes mellitus
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/diabetes-mellitus
Dyslipidaemia
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/dyslipidaemia
Exposure to phenoxy acid herbicides
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/exposure-phenoxy-acid-herbicides
Exposure to TCDD (Dioxin)
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/exposure-tcdd-dioxin
Haematological disorder associated with a hypercoagulable state
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/haematological-disorder-associated-hypercoagulable-state
Hyperhomocysteinaemia
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/hyperhomocysteinaemia
Hypertension
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/hypertension
Hypothyroidism
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/hypothyroidism
Immersion in an atmosphere with a visible tobacco smoke haze
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/immersion-atmosphere-visible-tobacco-smoke-haze
Inability to obtain appropriate clinical management for ischaemic heart disease
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/inability-obtain-appropriate-clinical-management-ischaemic-heart-disease
Inability to undertake any physical activity greater than 3 METs
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/inability-undertake-any-physical-activity-greater-3-mets
Inhaling or having cutaneous contact with nitroglycerine and nitroglycol
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/inhaling-or-having-cutaneous-contact-nitroglycerine-and-nitroglycol
Morbid obesity
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/morbid-obesity
Obesity or increased waist to hip ratio
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/obesity-or-increased-waist-hip-ratio
Pipe smoking
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/pipe-smoking
Smoking tobacco products - material contribution
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/smoking-tobacco-products-material-contribution
The death of a significant other
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/death-significant-other
Therapeutic radiation to the mediastinum or the chest wall overlying the heart
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/therapeutic-radiation-mediastinum-or-chest-wall-overlying-heart
Using amphetamines
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/using-amphetamines
Using nonsteroidal anti-inflammatory drugs
Current RMA Instruments
| 27 of 2025 as amended | |
| 28 of 2025 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: In the range I20 to I25
Brief description
Ischaemic heart disease is a condition caused by reduced and inadequate blood supply to part of the heart, resulting in infarction (death of heart tissue) or periodic ischaemia (temporary oxygen deprivation to the heart tissue). This occurs due to narrowing, thrombosis, vasospasm or dissection in the coronary arteries. The impairment can present clinically as angina, a myocardial infarct or sudden cardiac death.
Coronary atherosclerosis that has not resulted in ischaemia- angina, infarction or some other cardiac dysfunction, is not covered by this SoP.
Confirming the diagnosis
Establishing the diagnosis involves a thorough clinical assessment, including evaluation of cardiovascular risk factors, along with targeted cardiac investigations. These may include electrocardiograms (ECGs), blood tests (e.g. cardiac enzymes), and cardiac imaging such as echocardiography, nuclear stress testing, CT coronary angiography, and/or coronary angiography (cardiac catheterisation).
This diagnosis can typically be confirmed by General Practitioners, supported by clinical evidence of cardiac ischaemia. However, the assessment and ongoing management of the condition can often require input from a cardiologist, and any further clarifications may be sought through cardiology consultation.
Additional diagnoses covered by SOP
- Acute coronary syndrome (including STEMI, NSTEMI, and unstable angina)
- Angina pectoris (including unstable angina and Prinzmetal angina)
- Myocardial infarction (ST elevation infarction- STEMI)
- Myocardial ischaemia
- Ischaemia due to coronary artery dissection
- Ischaemic cardiomyopathy
Conditions not covered by SOP
- Coronary atherosclerosis, coronary atheroma, or coronary artery disease without ischaemia- e.g. coronary atherosclerosis found on investigation but there is no evidence of angina or infarction etc. #
- Myocardial infarction due to generalised hypoxia (e.g. severe anaemia, respiratory failure etc), vascular shock or cardiac arrest #
* another SOP applies
# non-SOP condition
Clinical onset
The clinical onset of ischaemic heart disease (IHD) is defined as either the first occurrence of symptoms subsequently confirmed to be attributable to IHD, or the initial detection of cardiac dysfunction due to IHD through investigation. The incidental finding of asymptomatic coronary atherosclerosis (e.g. on CT scan or angiography) does not constitute a clinical onset of IHD.
Clinical worsening
Most factors that contribute to the clinical onset of IHD- such as developing hypertension, hyperlipidaemia, smoking, diabetes and physical inactivity- can also contribute to its clinical progression or worsening. In addition, the course of IHD can be significantly influenced by timely and appropriate medical management. An inability to access or adhere to effective treatment, including medications, lifestyle interventions, or revascularisations procedures, may result in a sustained or permanent deterioration in cardiac function and overall prognosis.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/ischaemic-heart-disease-g006-i20-i25/rulebase-ischaemic-heart-disease/using-nonsteroidal-anti-inflammatory-drugs