M21-1 and 38 CFR changes, week of Nov 22, 2021

Added

• Transcutaneous oxygen tension (Tc PO2) is measured at the first intercostal space on the foot.
• Normal Tc PO2 is greater than or equal to 60 mm Hg.
• If AP, TP, and Tc PO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or Tc PO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the veteran's peripheral arterial disease.

and 1 more added passages

Removed

• Diseases of the Heart[Unless otherwise directed, use this general rating formula to evaluate diseases of the heart.] | Rating
• During active infection with valvular heart damage and for three months following cessation of therapy for the active infection | 100
• Thereafter, with valvular heart disease (documented by findings on physical examination and either echocardiogram, Doppler echocardiogram, or cardiac catheterization) resulting in:
• Chronic congestive heart failure, or;
• workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or;
• left ventricular dysfunction with an ejection fraction of less than 30 percent | 100
• More than one episode of acute congestive heart failure in the past year, or;
• workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or;

and 37 more removed passages