• Personal data, family and social history, contact details |
• Past medical history, co‐morbidities, surgeries and other procedures, allergies and adverse drug reactions, blood transfusions |
• HF aetiology, disease course, phenotype, device therapy, hospitalizations for decompensation |
• A review of medications and dosing, including possible side effects, need for changes and up‐titration goals |
• A clinical assessment of vital signs, cardiac rhythm, functional capacity, 6 min walk test, fluid status, nutritional and cognitive status |
• Reports of imaging (echocardiography, chest X‐ray, SPECT, coronary angiography, cardiac ΜRΙ), cardiorespiratory stress test with VO2 max, electrophysiology study and ablation, myocardial biopsy, genetic testing |
• Laboratory test results (serum urea, creatinine, electrolytes, haemoglobin, ferritin, TSH, NT proBNP) |
• Vaccinations |
• Consultation of other specialists |
• Free space for special notes |