Lesson 1Past cardiac history, prior heart failure, coronary disease, revascularization, arrhythmias, and hospitalizationsThis part shows how to get a proper past heart history, covering old heart failure, coronary issues, procedures, irregular heartbeats, and hospital stays, to better figure out diagnosis, outlook, and treatment paths.
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 dryThis part explains how to check chest pain, heart flutters, fainting spells, near-faints, fever, and coughs (wet or dry) step by step, to tell heart problems from others and spot urgent warning signs.
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 we set up questions on when breathlessness started, how long it lasts, how it worsens, and recent triggers, to spot sudden, building, or long-term patterns and causes like infection, poor blood flow, or skipping meds.
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 patternWe look at checking exercise ability, changes in daily tasks, and weight gain ways, using daily habits and recent shifts to measure fluid buildup, treatment response, and need for water pill tweaks or other fixes.
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 servicesThis part guides checking social life, daily function, home help, follow-up ability, and transport or emergency access, to plan safe going home, self-care, and extra community support needs.
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 we check water and salt intake, drink use, and recent med changes or misses, to pinpoint common triggers of sudden heart failure worsening and teach targeted patient advice.
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 useThis part covers sticking to meds, shop-bought drugs, herbal remedies, and recent painkillers or steroid use, pointing out things that worsen fluid hold, blood pressure, or kidney work in heart 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 apneaThis part gets other illnesses and risks like high blood pressure, sugar control, long-term lung issues, kidney problems, and sleep stops, stressing how well controlled they are and links to breath trouble 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 detailsWe dig into questions on breath trouble lying flat, sudden night breathlessness, and night coughs, covering start, how often, and position triggers, to separate heart failure from lung or throat night issues.
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 signsWe target symptoms hinting other issues like lung clots, chest infection, lung collapse, or brain events, teaching questions to tell them from main heart failure signs.
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
