1) Do you get short of breath at rest? |
2) Do you get short of breath with minimal exertion? (eg, walking across a room, doing light housework, putting on your shoes, talking on the telephone) |
3) How far can you walk before stopping due to shortness of breath? |
4) How far can you walk on an incline before stopping? |
5) How many flights of stairs can you climb before stopping? |
6) For how long have you felt short of breath? |
7) Do you have chest pain with exertion? |
8) Do you have any trouble breathing while you sleep or lie flat in bed? |
9) Have you ever passed out? |
10) Have you ever felt you were about to pass out? |
11) Do you have any dizziness or light-headedness at rest or with exertion? |
12) Do you have swelling in your legs? |
13) Do you have swelling in your abdomen? |
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