SURVEY ON PATIENT OF HEART FAILURE


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* 1. PATIENT INFORMATION

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* 2. YOUR JOB IN OFFICE INCLUDE :

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* 3. WHAT WERE THE SYMPTOMS EXPERIENCED BY YOU BEFORE KNOWING THE DISEASE?

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* 4. AGE WHEN YOU FIRST EXPERIENCED THES SYMPTOMS:

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* 5. DIAGNOSTIC TEST PROCEDURE CARRIED OUT TO DETECT CONGESTIVE HEART FAILURE

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* 6. EJECTION FRACTION OF HEART

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* 7. HAVE YOU EVER HAD ANY OF THE FOLLOWING PROCEDURE 

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* 8. MEDICATION PRESCRIBED BY YOUR CARDIOLOGIST FOR HAERT FAILURE:

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* 9. AT WHAT TIME INTERVAL DO YOU VISIT YOUR CARDIOLOGIST?

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* 10. ANY PREVENTIVE MEASURES TAKEN BY YOU/ SUGGESTED BY YOUR CARDIOLOGIST?

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