Cardiovascular History	Yes / No
Do you ever have chest pain?	Y
Do you ever have shortness of breath?	Y
Do you get shortness of breath with stair climbing?	Y
Do you get chest pain with stair climbing?	N
Do you ever experience ankle swelling?	N
Do you get leg cramps when walking?	N
Do you awaken at night with chest pain?	N
Do you awaken at night with shortness of breath?	N
Do you ever experience irregular or "funny feeling" heart beats?	N

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