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