Here’s your one-page printable cardiology visit checklist — laid out so you can print it, take it to your appointments, and jot answers in the blank spaces.
CARDIOLOGY VISIT CHECKLIST
(For Mild CHF, AFib, Watchman Device, CPAP)
Patient Name: _____________________ Date: _____________ Doctor: _____________________
Heart Function
1. Current ejection fraction (EF): ________________________
2. Change since last test? __________________________________
3. Heart failure type (systolic / diastolic / both): ___________
4. Echocardiogram frequency: ______________________________
Labs & BNP
5. BNP / NT-proBNP level: _________________________________
6. My baseline BNP: ______________________________________
7. Plan if BNP rises: ______________________________________
8. Kidney function & electrolytes checked how often? _________
Medications
9. Current Lasix dose appropriate? _______________________
10. On full heart failure guideline medications? (Y/N) ______
List: ________________________________________________
11. AFib medication changes needed? ________________________
AFib & Watchman Device
12. AFib rate and rhythm control: ___________________________
13. Watchman device sealed on imaging? _____________________
14. Antiplatelet / blood thinner still needed? ________________
Sleep Apnea
15. CPAP therapy effective? ________________________________
16. CPAP setting adjustments needed? ________________________
Monitoring & Lifestyle
17. Weigh daily? (Y/N) ______ Trigger weight gain: ___________
18. Daily sodium limit: _____________________________________
19. Fluid restriction: ______________________________________
20. Symptoms to call about immediately: _____________________
Notes: