Lesson 1Past cardiac history, prior heart failure, coronary disease, revascularization, arrhythmias, and hospitalizationsThis part shows how to get exact details on past heart problems like old heart failure, blocked arteries, fixes done, irregular beats, and hospital stays to sharpen diagnosis, outlook, and treatment choices.
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 checking chest pain, heart flutters, fainting spells, near-faints, fever, and coughs that bring stuff up or stay dry, to tell heart issues from others and spot urgent dangers.
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 shape questions on when breathlessness started, how long it lasts, how it worsens, and recent triggers like sickness, poor blood flow, or skipping meds to spot sudden, building, or long-term patterns.
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 life stories and recent shifts to measure fluid buildup, treatment response, and need for water pill changes.
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 reach to transport or emergency help, to plan safe going home, self-care, and extra community aid.
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 taken in, alcohol drinking, and recent med changes or skips, to clear common causes of sudden heart failure worsening and guide direct teaching and 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 boost fluid hold, blood pressure, or kidney strain 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 hold, sugar control, long lung sickness, kidney trouble, and sleep breathing stops, stressing control levels and links affecting breath trouble and heart failure badness.
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, with start time, how often, and position triggers, to split 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 signs of other troubles like lung clots, lung infection, collapsed lung, or brain events, teaching pointed questions to tell them from main heart failure shows.
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
