Lesson 1Past cardiac history, prior heart failure, coronary disease, revascularization, arrhythmias, and hospitalizationsDis section review how fi get a precise past cardiac history, includin prior heart failure, coronary disease, revascularization, arrhythmias, an hospitalizations, fi refine differential diagnosis, prognosis, an therapeutic options.
Documented heart failure diagnosisCoronary disease and prior MI detailsPCI, CABG, and other revascularizationHistory of atrial or ventricular arrhythmiasPrior cardiac and HF hospitalizationsBaseline LVEF and prior imagingLesson 2Associated symptoms: chest pain, palpitations, syncope, presyncope, fever, cough productive vs dryDis section detail how fi systematically explore chest pain, palpitations, syncope, presyncope, an respiratory or infectious symptoms, helpin distinguish cardiac from noncardiac causes an identify red flags needin urgent escalation.
Character and timing of chest painPalpitations pattern and triggersSyncope and presyncope red flagsFever, chills, and infection cluesCough type, sputum, and hemoptysisPleuritic versus pressure-like painLesson 3Onset, duration, and progression of breathlessness and recent precipitating eventsHere wi structure questions pon onset, duration, an progression a breathlessness, along wid recent precipitating events, fi distinguish acute, subacute, an chronic patterns an identify triggers like infection, ischemia, or nonadherence.
Exact onset and time course of dyspneaStable, improving, or worsening patternTriggers: exertion, rest, or recumbencyRecent infections, fevers, or travelDietary or medication nonadherenceRecent surgery, trauma, or pregnancyLesson 4Exercise tolerance, daily activity changes, and weight gain patternWi explore how fi evaluate exercise tolerance, daily activity changes, an weight gain patterns, usin functional history an recent trends fi gauge congestion, response to therapy, an need fi adjustment a diuretics or other treatments.
Baseline versus current activity levelDyspnea with stairs or short walksRecent reduction in daily activitiesDaily weight monitoring practicesRapid weight gain and fluid retentionImpact on work and caregiving rolesLesson 5Social and functional status, support at home, ability to attend follow-up, and access to transport/emergency servicesDis section guide assessment a social an functional status, home support, follow-up capacity, an access to transport or emergency services, informin safe discharge planning, self-management, an need fi additional community resources.
Living situation and caregiver supportAbility to perform basic daily tasksHealth literacy and self-management skillsReliability of transport to follow-upAccess to pharmacy and emergency careFinancial or insurance constraintsLesson 6Fluid intake, salt intake, alcohol use, and recent medication changes or missed dosesHere wi focus pon assessin fluid an salt intake, alcohol use, an recent medication changes or missed doses, clarifyin common precipitants a acute decompensated heart failure an guidin targeted patient education an counseling.
Daily fluid volume and restrictionsDietary sodium sources and habitsAlcohol quantity, pattern, and bingesRecent new or stopped medicationsMissed doses of heart failure drugsPatient understanding of regimenLesson 7Medication adherence, over-the-counter drugs, complementary medicines, and recent NSAID or steroid useDis section address medication adherence, over-the-counter drugs, complementary therapies, an recent NSAID or steroid use, highlightin agents dat worsen fluid retention, blood pressure, or renal function in heart failure patients.
Barriers to taking prescribed medicinesUse of OTC cold and pain remediesRecent NSAID or COX-2 inhibitor useSystemic or inhaled steroid exposureHerbal and complementary productsPharmacy reconciliation and recordsLesson 8Comorbidities and risk factors: hypertension control, diabetes control, chronic lung disease, renal disease, and sleep apneaDis section cover elicitin comorbidities an risk factors, includin hypertension, diabetes, chronic lung disease, renal disease, an sleep apnea, emphasizin control status an interactions dat influence acute dyspnea an heart failure severity.
Hypertension history and control levelDiabetes duration and complicationsCOPD, asthma, and lung function historyChronic kidney disease stage and trendsScreening for sleep apnea symptomsObesity, smoking, and lipid profileLesson 9Orthopnea, paroxysmal nocturnal dyspnea, and nocturnal cough detailsWi examine targeted questioning bout orthopnea, paroxysmal nocturnal dyspnea, an nocturnal cough, includin onset, frequency, an positional triggers, fi differentiate heart failure from pulmonary or upper airway causes a nighttime symptoms.
Number of pillows and sleep positionTiming and frequency of PND episodesNocturnal cough pattern and triggersRelief with sitting or standing upOverlap with reflux or asthma symptomsImpact on sleep quality and fatigueLesson 10Symptoms suggesting alternative diagnoses: unilateral leg pain/swelling, hemoptysis, fever, pleuritic chest pain, or neurologic signsWi focus pon symptoms suggestin alternative diagnoses, such as pulmonary embolism, pneumonia, pneumothorax, or neurologic events, teachin targeted questions dat help differentiate dese from primary heart failure presentations.
Unilateral leg pain or swelling historyPleuritic chest pain and PE suspicionFocal neurologic deficits or confusionHigh fever, rigors, and pneumonia cluesSudden onset dyspnea and pneumothoraxRed flags requiring urgent escalation
