Military Medical Standards for Enlistment & Appointment

Heart and Vascular System

The disqualifying medical conditions are listed below. The International Classification of Disease (ICD) codes are listed in parentheses following each standard.

The causes for rejection for appointment, enlistment, and induction (without an approved waiver) are an authenticated history of:


Current or history of all valvular heart diseases, congenital (746) or acquired (394), including those improved by surgery, are disqualifying. Mitral valve prolapse or bicuspid aortic valve is not disqualifying unless there is associated tachyarrhythmia, mitral regurgitation, aortic stenosis, insufficiency, or cardiomegaly.

Current or history coronary heart disease (410) is disqualifying.

Current or history of symptomatic arrhythmia or electrocardiographic evidence of arrhythmia.

Current or history of supraventricular tachycardia (427.0), or any arrhythmia originating from the atrium or sinoatrial node, such as atrial flutter, and atrial fibrillation, unless there has been no recurrence during the preceding 2 years while off all medications, is disqualifying.

Premature atrial or ventricular contractions sufficiently symptomatic to require treatment, or result in physical or psychological impairment, are disqualifying.

Current or history of ventricular arrhythmias (427.1), including ventricular fibrillation, tachycardia, or multifocal premature ventricular contractions, is disqualifying. Occasional asymptomatic unifocal premature ventricular contractions are not disqualifying.

Current or history of ventricular conduction disorders, including, but not limited to disorders with left bundle branch block (426.2), Mobitz type II second degree atrioventricular (AV) block (426.12), and third degree AV block (426.0). and Lown-Ganong-Levine-Syndrome (426.81) associated with an arrhythmia are disqualifying. Current or history of Wolff-Parkinson-White Syndrome (426.7), unless it has been successfully ablated for a period of 2 years without recurrence of arrhythmia and now with a normal electrocardiogram, is disqualifying.

Current or history of conduction disturbances such as first degree AV block (426.11), left anterior hemiblock (426.2), right bundle branch block (426.4), or Mobitz type I second degree AV block (426.13) are disqualifying when symptomatic or associated with underlying cardiovascular disease.

Current cardiomegaly, hypertrophy or dilatation of the heart (429.3) are disqualifying.

Current or history of cardiomyopathy (425), including myocarditis (422), or congestive heart failure (428), is disqualifying.

Current or history of pericarditis (420) (acute nonrheumatic), unless the individual is free of all symptoms for 2 years, and has no evidence of cardiac restriction or persistent pericardial effusion, is disqualifying.

Current persistent tachycardia (785.1) (resting pulse rate of 100 beats per minute or greater) is disqualifying.

Current or history of congenital anomalies of heart and great vessels (746), except for corrected patent ductus arteriosus, are disqualifying.

Vascular system

Current or history of abnormalities of the arteries and blood vessels (447), including, but not limited to aneurysms (442), atherosclerosis (440), or arteritis (446), are disqualifying.

Current or history of hypertensive vascular disease (401) is disqualifying. Elevated blood pressure defined as the average of three consecutive sitting blood pressure measurements separated by at least 10 minutes, diastolic greater than 90 mmHg or three consecutive systolic pressure measurements greater than 140 mmHg is disqualifying (796.2).

History of pulmonary (415) or systemic embolization (444) is disqualifying.

Current or history of peripheral vascular disease (443), including, but not limited to diseases such as Raynaud’s Disease (443.0) is disqualifying.

Current or history of venous diseases, including but not limited to, recurrent thrombophlebitis (451), thrombophlebitis during the preceding year, or any evidence of venous incompetence, such as large or symptomatic varicose veins, edema, or skin ulceration (454), is disqualifying.

Derived from Department of Defense (DOD) Directive 6130.3, "Physical Standards for Appointment, Enlistment, and Induction," and DOD Instruction 6130.4, "Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces."

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