Demographic data | Age (years) |
Gender (female) | |
Height (cm) | |
Weight (kg) | |
BMI (kg/m2) | |
Prior medical conditions | Hypertension |
Congestive cardiac failure | |
Angina | |
Myocardial infarction | |
Coronary intervention | |
Known significant valve disease | |
Valve replacement | |
Cardiac arrhythmia | |
Pulmonary hypertension | |
COPD | |
Interstitial lung disease | |
Asthma | |
Smoking | |
Diabetes | |
Known renal failure | |
Stroke | |
HIV | |
Venous thromboembolism | |
Cancer (type, active/remission, metastasis) | |
Chronic liver disease | |
Hypothyroidism | |
Hyperthyroidism | |
Cognitive impairment/dementia | |
Chronic medication | Antihypertensive |
Beta-blockers | |
Antiplatelet | |
Anticoagulant | |
Systemic steroids | |
Diuretics | |
Chemotherapy | |
Other | |
Cardiopulmonary symptoms | Dyspnea/shortness of breath |
Chest pain | |
Palpitations | |
Cough | |
Fever suspected to be respiratory or cardiac | |
Lower limb edema | |
Altered state of consciousness | |
Other | |
Vital signs | Blood pressure (mmHg) |
Heart rate (beats per minute) | |
Temperature (°C) | |
Respiratory rate (breaths per minute) | |
O2 saturation (%) |