Reasonable Hypothesis [1] | 13 of 2022 |
Balance of Probabilities [2] | 14 of 2022 |
SOP Bulletin 228 [3]
Aortic stenosis is a narrowing of the opening of the aortic valve in the heart. This narrowing restricts blood flow from the left ventricle of the heart into the aorta.
The diagnosis may be provisionally made from findings on clinical examination and is generally confirmed by echocardiogram (heart ultrasound). Cardiac catheterisation may be undertaken in some cases and provides a definitive diagnosis. Symptoms are not required for diagnosis but will typically be present. Note that aortic stenosis due to rheumatic fever is covered by a different SOP. Obstruction to blood flow due to narrowing above or below the aortic valve is not covered by this SOP.
The relevant medical specialist is a cardiologist.
* another SOP applies
# non-SOP condition
Clinical onset will generally be at the time of diagnosis. The condition is asymptomatic in most mild to moderate cases. In severe cases non-specific symptoms of shortness of breath, angina and fainting spells (syncope) may occur.
Gradual progresion of disease is usual. Evidence of deterioration beyond the normal course of the disease is required for clinical worsening to be considered. Appropriate treatment involves monitoring of the condition in the early stages. Medical therapy is ineffective. Surgical treatment may become necessary for more severe disease.
Place holder node for Rulebase for aortic stenosis
Aortic stenosis - Chronic renal failure Factor
Last reviewed for CCPS 20 December 2002.
Preliminary questions [32331]
9041 [5] there is some evidence that chronic renal failure may be a factor in the development or worsening of the condition under consideration.
32332 [6] the veteran has chronic renal failure which required renal dialysis or renal transplantation.
32333 — the veteran has established the causal connection between the chronic renal failure and VEA service for aortic stenosis.
32334 [7] the veteran was suffering from chronic renal failure, which required renal dialysis or renal transplantation, before the clinical onset of the condition under consideration. 32335 — the veteran has established the causal connection between the chronic renal failure and VEA service for the clinical onset of aortic stenosis. 32338 — the veteran has established the causal connection between the chronic renal failure and operational service for the clinical onset of aortic stenosis. or 32339 — the veteran has established the causal connection between the chronic renal failure and eligible service for the clinical onset of aortic stenosis. or 32337 — the veteran has established the causal connection between the chronic renal failure and VEA service for the clinical worsening of aortic stenosis. 32340 — the veteran has established the causal connection between the chronic renal failure and operational service for the clinical worsening of aortic stenosis. or 32341 — the veteran has established the causal connection between the chronic renal failure and eligible service for the clinical worsening of aortic stenosis. Clinical onset and operational service [32338] 32342 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to operational service. [11] [12] Clinical onset and eligible service [32339] 32343 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to eligible service. [13] [12] Clinical worsening and operational service [32340] 32342 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to operational service. [14] [12] Clinical worsening and eligible service [32341] 32343 — the chronic renal failure, which required renal dialysis or renal transplantation, is causally related to eligible service. [16] [12]
Aortic stenosis - Hypertension Factor
Last reviewed for CCPS 20 December 2002.
Preliminary questions [32351]
317 [19] the veteran has hypertension. 32352 — the veteran has established the causal connection between the hypertension and operational service for aortic stenosis. 32353 — the veteran has established the causal connection between the hypertension and operational service for the clinical onset of aortic stenosis. or 32354 — the veteran has established the causal connection between the hypertension and operational service for the clinical worsening of aortic stenosis. Clinical onset and operational service [32353] 334 — the hypertension is causally related to operational service. [22] Clinical worsening and operational service [32354] 334 — the hypertension is causally related to operational service. [23]
Aortic stenosis - Inability to obtain appropriate clinical management for aortic stenosis Factor
Last reviewed for CCPS 20 December 2002.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [32577] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [27] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [28] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [33] [34] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [33] [34]
Aortic stenosis - Infective endocarditis Factor
Last reviewed for CCPS 20 December 2002.
Preliminary questions [11303]
11327 [41] the veteran has had infective endocarditis at some time.
11328 [42] the veteran has suffered from an identifiable form of infective endocarditis, an inflammation of the endocardium caused by infection with microorganisms. 11329 — the veteran has established the causal connection between the identified illness or injury, a type of infective endocarditis, and VEA service for the condition under consideration. 11330 — the veteran has established the causal connection between the infective endocarditis and VEA service for the clinical onset of the condition under consideration. 11332 — the veteran has established the causal connection between the infective endocarditis and operational service for the clinical onset of the condition under consideration. or 11333 — the veteran has established the causal connection between the infective endocarditis and eligible service for the clinical onset of the condition under consideration. or 11331 — the veteran has established the causal connection between the infective endocarditis and VEA service for the clinical worsening of the condition under consideration. 11334 — the veteran has established the causal connection between the infective endocarditis and operational service for the clinical worsening of the condition under consideration. or 11335 — the veteran has established the causal connection between the infective endocarditis and eligible service for the clinical worsening of the condition under consideration. Clinical onset and operational service [11332] 11338 — the identified illness or injury, a type of infective endocarditis, is causally related to operational service. [45] [46] Clinical onset and eligible service [11333] 11339 — the identified illness or injury, a type of infective endocarditis, is causally related to eligible service. [47] [46] Clinical worsening and operational service [11334] 11338 — the identified illness or injury, a type of infective endocarditis, is causally related to operational service. [48] [46] Clinical worsening and eligible service [11335] 11339 — the identified illness or injury, a type of infective endocarditis, is causally related to eligible service. [50] [46]
Aortic stenosis - Systemic lupus erythematosus Factor
Last reviewed for CCPS 20 December 2002.
Preliminary questions [11304]
21956 [53] there is some evidence that systemic lupus erythematosus may be a factor in the development or worsening of the condition under consideration.
2576 [53] the veteran has had systemic lupus erythematosus at some time. 11342 — the veteran has established the causal connection between the systemic lupus erythematosus and VEA service for the condition under consideration. 11343 — the veteran has established the causal connection between the systemic lupus erythematosus and VEA service for the clinical onset of the condition under consideration. 11345 — the veteran has established the causal connection between the systemic lupus erythematosus and operational service for the clinical onset of the condition under consideration. or 11346 — the veteran has established the causal connection between the systemic lupus erythematosus and eligible service for the clinical onset of the condition under consideration. or 11344 — the veteran has established the causal connection between the systemic lupus erythematosus and VEA service for the clinical worsening of the condition under consideration. 11347 — the veteran has established the causal connection between the systemic lupus erythematosus and operational service for the clinical worsening of the condition under consideration. or 11352 — the veteran has established the causal connection between the systemic lupus erythematosus and eligible service for the clinical worsening of the condition under consideration. Clinical onset and operational service [11345] 2582 — the systemic lupus erythematosus is causally related to operational service. [56] [57] Clinical onset and eligible service [11346] 2583 — the systemic lupus erythematosus is causally related to eligible service. [58] [57] Clinical worsening and operational service [11347] 2582 — the systemic lupus erythematosus is causally related to operational service. [59] [57] Clinical worsening and eligible service [11352] 2583 — the systemic lupus erythematosus is causally related to eligible service. [61] [57]
Aortic stenosis - Therapeutic radiation to the mediastinum or the chest wall overlying the heart Factor
Last reviewed for CCPS 20 December 2002.
Preliminary questions [26989]
26990 [64] there is some evidence that therapeutic radiation involving the mediastinum or the chest wall region overlying the heart may be a factor in the development or worsening of the condition under consideration.
26991 [64] the veteran has undergone a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart at some time.
26994 [65] the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart as treatment for an illness or injury which is identifiable. 26992 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the condition under consideration. 26993 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the clinical onset of the condition under consideration. 26997 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and operational service for the clinical onset of the condition under consideration. or 26998 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and eligible service for the clinical onset of the condition under consideration. or 26996 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the clinical worsening of the condition under consideration. 26999 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and operational service for the clinical worsening of the condition under consideration. or 27000 — the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and eligible service for the clinical worsening of the condition under consideration. Clinical onset and operational service [26997] 27004 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to operational service. [68] [69] Clinical onset and eligible service [26998] 27005 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to eligible service. [70] [69] Clinical worsening and operational service [26999] 27004 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to operational service. [71] [69] Clinical worsening and eligible service [27000] 27005 — the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to eligible service. [73] [69]
Links
[1] http://www.rma.gov.au/assets/SOP/2022/a8bab49d76/013.pdf
[2] http://www.rma.gov.au/assets/SOP/2022/617a7589d2/014.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20228.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63284%23comment-form
[5] https://clik.dva.gov.au/ccpsk010rc-23
[6] clikpopup://CCPS/Chronic renal failure required renal dialysis or renal transplantation
[7] clikpopup://CCPS/Chronic renal failure required renal dialysis or renal transplantation before onset
[8] clikpopup://CCPS/reject32334No
[9] clikpopup://CCPS/Reject/OnsetAfterService
[10] clikpopup://CCPS/Reject/NoPermanentWorsening
[11] clikpopup://CCPS/reject32336No
[12] clikpopup://CCPS/reject32342,32343No
[13] clikpopup://CCPS/reject32343No
[14] clikpopup://CCPS/reject32342No
[15] clikpopup://CCPS/Onset prior to operational chronic renal failure requiring renal dialysis or renal transplantation
[16] clikpopup://CCPS/reject32344No
[17] clikpopup://CCPS/Onset prior to eligible chronic renal failure requiring renal dialysis or renal transplantation
[18] clikpopup://CCPS/reject32345No
[19] https://clik.dva.gov.au/ccpsg020rc
[20] clikpopup://CCPS/reject317No
[21] clikpopup://CCPS/reject32355No
[22] clikpopup://CCPS/reject32356No
[23] clikpopup://CCPS/reject334No
[24] clikpopup://CCPS/Onset occurred prior to operational service to which hypertension is causally related
[25] clikpopup://CCPS/reject7899No
[26] https://clik.dva.gov.au/ccpsother-31
[27] https://clik.dva.gov.au/node/68642
[28] clikpopup://CCPS/Aortic stenosis/ACM - contributed to worsening
[29] clikpopup://CCPS/ACM/NoContribution
[30] clikpopup://CCPS/ACM/NotOpService
[31] clikpopup://CCPS/ACM/NotOperDuties
[32] clikpopup://CCPS/rejectwilful
[33] clikpopup://CCPS/ACM/NoIllness
[34] clikpopup://CCPS/reject7390,7391No
[35] clikpopup://CCPS/Aortic stenosis/ACM - onset prior to operational service
[36] clikpopup://CCPS/ACM/OnsetFailOper
[37] clikpopup://CCPS/ACM/NotEligService
[38] clikpopup://CCPS/ACM/NotEligDuties
[39] clikpopup://CCPS/Aortic stenosis/ACM - onset prior to eligible service
[40] clikpopup://CCPS/ACM/OnsetFailElig
[41] https://clik.dva.gov.au/ccpsg036rc-35
[42] https://clik.dva.gov.au/11303-infective-endocarditis
[43] clikpopup://CCPS/reject11328No
[44] clikpopup://CCPS/reject11336No
[45] clikpopup://CCPS/reject11337No
[46] clikpopup://CCPS/reject11338,11339No
[47] clikpopup://CCPS/reject11339No
[48] clikpopup://CCPS/reject11338No
[49] clikpopup://CCPS/Onset of aortic stenosis prior to operational service to which infective endocarditis is related
[50] clikpopup://CCPS/reject11340No
[51] clikpopup://CCPS/Onset of aortic stenosis prior to eligible service to which infective endocarditis is related
[52] clikpopup://CCPS/reject11341No
[53] https://clik.dva.gov.au/ccpsf001rc-0
[54] clikpopup://CCPS/reject2576No
[55] clikpopup://CCPS/reject11348No
[56] clikpopup://CCPS/reject11349No
[57] clikpopup://CCPS/reject2582,2583No
[58] clikpopup://CCPS/reject2583No
[59] clikpopup://CCPS/reject2582No
[60] clikpopup://CCPS/Onset of aortic stenosis prior to operational service to which systemic lupus erythematosus is related
[61] clikpopup://CCPS/reject11350No
[62] clikpopup://CCPS/Onset of aortic stenosis prior to eligible service to which systemic lupus erythematosus is related
[63] clikpopup://CCPS/reject11351No
[64] https://clik.dva.gov.au/ccpsg006rc-15
[65] clikpopup://CCPS/Therapeutic radiation involving the mediastinum or chest wall region overlying the heart for illness or injury
[66] clikpopup://CCPS/reject26994No
[67] clikpopup://CCPS/reject33440No
[68] clikpopup://CCPS/reject26995No
[69] clikpopup://CCPS/reject27004,27005No
[70] clikpopup://CCPS/reject27005No
[71] clikpopup://CCPS/reject27004No
[72] clikpopup://CCPS/Onset of aortic stenosis prior to operational service which ill/inj requiring therapeutic radiation is causally related
[73] clikpopup://CCPS/reject27006No
[74] clikpopup://CCPS/Onset of aortic stenosis prior to eligible service which ill/inj requiring therapeutic radiation is causally related
[75] clikpopup://CCPS/reject27007No