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Heart Attack (arteriosclerotic heart disease) Personal Health Assessment
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1) Have you had a heart attack?
*
Yes
No
2) Have you had any of the following complications of heart disease?
*
Angina
Congestive Heart Failure
Abnormal Heart Rhythm
No, I don't have any of these problems
3) Are you considering having a heart stent or bypass operation?
*
Yes
No
4) Do you have a problem with cholesterol?
*
Yes
No
5) Are you taking any of these medications for your heart?
*
Anticoagulants: Aspirin, Plavix, and/or Coumadin
Diuretics
Antiarrhymics
Blood pressure medication
Diabetes medications
Statins
Drugs for angina
No
6) Are you taking supplements for your heart?
*
Yes
No
7) Are any of these laboratory blood tests abnormal?
*
Cholesterol
Triglycerides
Lipoprotein (a)
Homocysteine
Iron
Fasting Insulin
CRP
Fibrinogen
I have not had any of these blood tests
8) Have you taken any of the following tests of heart function?
*
Heart Rate Variability
Vascular Stiffness
Live Blood Cell Analysis
Heart Scan
Coronary Arteriogram
No, I have not taken any of these tests
9) Do you have any of these disorders that predispose to heart attacks?
*
Hypertension
Diabetes
Coagulation disorders
Anger Management Issues
Depression
High Cholesterol
Smoking
Overweight
No, I don't have any of these health problems
10) Are you interested in lifestyle management as a tool to improve your heart condition?
*
Yes
No
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