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| ID | Type | Description | Link |
|---|---|---|---|
| P30AG031679 | U.S. NIH Grant/Contract | View source | |
| P30AG048785 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Hebrew SeniorLife | OTHER |
| National Institute on Aging (NIA) | NIH |
| Beth Israel Deaconess Medical Center | OTHER |
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Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for older adults with severe symptomatic aortic stenosis who are considered high risk for surgical aortic valve replacement. Despite symptomatic and survival benefits, many patients experience functional decline after TAVR. This pilot study aims to test the feasibility of a home-based exercise intervention targeting endurance, strength, and balance as well as cognitive behavioral intervention to improve physical functioning and disability after TAVR.
We hypothesize that a home-based exercise program with cognitive behavioral intervention is more effective than home-based exercise alone; home-based exercise program with and without cognitive behavioral intervention is more effective than attention control educational intervention in preventing decline in physical function and disability after TAVR.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise & Cognitive Behavioral Int. | Experimental | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program and cognitive behavioral interventions. |
|
| Exercise Alone | Experimental | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program, without cognitive behavioral interventions. |
|
| Attention Control Education Program | Active Comparator | Participants will receive telephone-based education sessions from a study health professional. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Behavioral | Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the Late-Life Function and Disability Instrument (LLFDI) Score | The LLFDI is a validated patient-reported outcome questionnaire that measures both functional limitations (inability to perform physical tasks - Activity Limitation Domain score, range: 0-100) and disability (inability to perform major life tasks and social roles - Participation Restriction Domain score, range: 0-100). For both scales, higher values indicate better function (lower limitation or lower disability). Two domain scores are analyzed separately. | At baseline and week 8 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the Short Physical Performance Battery (SPPB) Summary Score | The summary score is calculated based on chair stands, walking speed, and standing balance (range: 0-12). Higher scores indicate better physical performance. | At baseline and week 8 |
| Change in the 2-Minute Walk Distance (Feet) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Mini-Mental State Examination (MMSE) Score | MMSE is an instrument that assesses general cognitive function (range: 0 to 30). Higher scores indicate better cognitive function. | At baseline and week 8 |
| Change in New York Heart Association (NYHA) Functional Class |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dae Hyun Kim, MD, MPH, ScD | Beth Israel Deaconess Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Brigham and Women's Hospital | Boston | Massachusetts | 02120 | United States | ||
| Hebrew SeniorLife |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40171799 | Derived | Shi SM, Rapley FA, Margulis H, Laham RJ, Guibone K, Percy E, Kaneko T, Wang KY, Kim DH. Home-Based Rehabilitation After Transcatheter Aortic Valve Replacement (REHAB-TAVR): A Pilot Randomized Controlled Trial. J Am Geriatr Soc. 2025 Jun;73(6):1836-1846. doi: 10.1111/jgs.19456. Epub 2025 Apr 2. | |
| 33962483 | Derived | Abraham LN, Sibilitz KL, Berg SK, Tang LH, Risom SS, Lindschou J, Taylor RS, Borregaard B, Zwisler AD. Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev. 2021 May 7;5(5):CD010876. doi: 10.1002/14651858.CD010876.pub3. |
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10 participants were disenrolled due to medical complications (n=5), rehabilitation facility discharge (n=2), and unavailability of the research team for assessment (n=3).
Between August 2017 and February 2020, 64 patients were enrolled from the Beth Israel Deaconess Medical Center and the Brigham and Women's Hospital in Boston, MA.
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| ID | Title | Description |
|---|---|---|
| FG000 | Exercise & Cognitive Behavioral Int. | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program and cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. Cognitive behavioral interventions: The following cognitive-behavioral strategies will be employed: 1) enhance positive beliefs about exercise through discussion of benefits of exercise; 2) discussion of barriers to exercise; 3) individualized goal setting and self-monitoring progress using exercise calendar; 4) develop a detailed exercise plan on how, what, when, and where to conduct exercise; 5) $10 rewards for exercising ≥30 mins per day for ≥5 of 7 days. The duration of this intervention is about 20 mins. |
| FG001 | Exercise Alone | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program, without cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. |
| FG002 | Attention Control Education Program | Participants will receive telephone-based education sessions from a study health professional. Attention control education program: A health care professional will call the participant weekly for a period of 8 weeks to teach general tips about exercise and diet (source: https://go4life.nia.nih.gov/). No recommendations for a specific exercise program will be made, except for walking 30 minutes daily or as tolerated. Each telephone session will cover 4 exercise tips and 4 healthy eating tips. The duration of the intervention is about 30 minutes. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Three patients (exercise alone n=2, attention control education n=1) were disenrolled after randomization because they developed medical complications or were discharged to a rehabilitation facility (exclusion criteria).
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| ID | Title | Description |
|---|---|---|
| BG000 | Exercise & Cognitive Behavioral Int. | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program and cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. Cognitive behavioral interventions: The following cognitive-behavioral strategies will be employed: 1) enhance positive beliefs about exercise through discussion of benefits of exercise; 2) discussion of barriers to exercise; 3) individualized goal setting and self-monitoring progress using exercise calendar; 4) develop a detailed exercise plan on how, what, when, and where to conduct exercise; 5) $10 rewards for exercising ≥30 mins per day for ≥5 of 7 days. The duration of this intervention is about 20 mins. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in the Late-Life Function and Disability Instrument (LLFDI) Score | The LLFDI is a validated patient-reported outcome questionnaire that measures both functional limitations (inability to perform physical tasks - Activity Limitation Domain score, range: 0-100) and disability (inability to perform major life tasks and social roles - Participation Restriction Domain score, range: 0-100). For both scales, higher values indicate better function (lower limitation or lower disability). Two domain scores are analyzed separately. | The LLFDI Computer Adaptive Test software for Windows could not be run after the Windows operating system upgrade during our study period. LLFDI scores were available for 36 participants at baseline and 10 participants at 8 weeks. Therefore, we were unable to analyze the LLFDI score change. Instead, we measured a disability score (count of 22 daily activities and physical tasks that a person cannot perform without another person's help) post-hoc (see post-hoc outcome measure). | Posted | Mean | Standard Deviation | units on a scale | At baseline and week 8 |
|
Adverse events were collected during the 8-week intervention period.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Exercise & Cognitive Behavioral Int. | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program and cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. Cognitive behavioral interventions: The following cognitive-behavioral strategies will be employed: 1) enhance positive beliefs about exercise through discussion of benefits of exercise; 2) discussion of barriers to exercise; 3) individualized goal setting and self-monitoring progress using exercise calendar; 4) develop a detailed exercise plan on how, what, when, and where to conduct exercise; 5) $10 rewards for exercising ≥30 mins per day for ≥5 of 7 days. The duration of this intervention is about 20 mins. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Chest pain | Cardiac disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
The primary outcome measure instrument, LLFDI Computer Adaptive Test software for Windows, could not be run after Windows operating system update during the study period. The software was not maintained by the developer to keep up with the latest version of the operating system. As a result, LLFDI measure was not measured for most participants at 8 weeks. The investigators measured a disability score (22 daily activities and physical tasks), which is highly correlated with LLFDI scores.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Dae Hyun Kim, Associate Scientist | Hebrew SeniorLife Marcus Institute for Aging Research | 617-632-5362 | daehyunkim@hsl.harvard.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 9, 2021 | Jun 4, 2021 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D001024 | Aortic Valve Stenosis |
| D009043 | Motor Activity |
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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|
| Cognitive behavioral interventions | Behavioral | The following cognitive-behavioral strategies will be employed: 1) enhance positive beliefs about exercise through discussion of benefits of exercise; 2) discussion of barriers to exercise; 3) individualized goal setting and self-monitoring progress using exercise calendar; 4) develop a detailed exercise plan on how, what, when, and where to conduct exercise; 5) $10 rewards for exercising ≥30 mins per day for ≥5 of 7 days. The duration of this intervention is about 20 mins. |
|
| Attention control education program | Behavioral | A health care professional will call the participant weekly for a period of 8 weeks to teach general tips about exercise and diet (source: https://go4life.nia.nih.gov/). No recommendations for a specific exercise program will be made, except for walking 30 minutes daily or as tolerated. Each telephone session will cover 4 exercise tips and 4 healthy eating tips. The duration of the intervention is about 30 minutes. |
|
The 2-minute walk distance measures endurance. A longer distance indicates better endurance. |
| At baseline and week 8 |
| Change in Dominant Hand Grip Strength (kg) | Dominant hand grip strength measures upper extremity strength. | At baseline and week 8 |
| Number of Participants Who Experienced Adverse Events | Number of participants who experience any adverse events and serious adverse events | At week 8 |
NYHA assesses the extent of physical activity limitation due to heart failure. It ranges from 1 (ordinary physical activity does not cause symptoms) to 4 (symptoms occur at rest). |
| At baseline and week 8 |
| Change in the Self-Efficacy Scale for Exercise (SEE) | The SEE scale measures self-efficacy about exercise (range: 0-90). Higher values indicate higher self efficacy. | At baseline and week 8 |
| Change in the Outcome Expectation Scale for Exercise (OEE) | The OEE scale measures outcome expectation about exercise (range: 9-45). Higher scores indicate higher expectation. | At baseline and week 8 |
| Adherence to the Home-based Exercise Program | The proportion of days with completed daily task during the entire study period will be measured. | At week 8 |
| Boston |
| Massachusetts |
| 02131 |
| United States |
| Beth Israel Deaconess Medical Center | Boston | Massachusetts | 02215 | United States |
| BG001 | Exercise Alone | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program, without cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. |
| BG002 | Attention Control Education Program | Participants will receive telephone-based education sessions from a study health professional. Attention control education program: A health care professional will call the participant weekly for a period of 8 weeks to teach general tips about exercise and diet (source: https://go4life.nia.nih.gov/). No recommendations for a specific exercise program will be made, except for walking 30 minutes daily or as tolerated. Each telephone session will cover 4 exercise tips and 4 healthy eating tips. The duration of the intervention is about 30 minutes. |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| New York Heart Association Class 3-4 | The New York Heart Association Class ranges from 1 (ordinary physical activity does not cause symptoms) to 4 (symptoms occur at rest). | Count of Participants | Participants |
|
| Aortic valve area | Mean | Standard Deviation | cm^2 |
|
| Left ventricular ejection fraction | Left ventricular ejection fraction measures the percentage of blood leaving your left ventricle each time heart contracts. | Mean | Standard Deviation | % |
|
| Body mass index | Mean | Standard Deviation | kg/m2 |
|
| At risk of malnutrition | Count of Participants | Participants |
|
| Mini-Mental State Examination score | The Mini-Mental State Examination measures cognitive function. The score ranges from 0 (worst cognitive function) to 30 (better cognitive function). | Mean | Standard Deviation | units on a scale |
|
| Activities of daily living dependence | Count of Participants | Participants |
|
| Instrumental activities of daily living dependence | Count of Participants | Participants |
|
| Gait speed | Mean | Standard Deviation | meter/second |
|
| OG000 | Exercise & Cognitive Behavioral Int. | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program and cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. Cognitive behavioral interventions: The following cognitive-behavioral strategies will be employed: 1) enhance positive beliefs about exercise through discussion of benefits of exercise; 2) discussion of barriers to exercise; 3) individualized goal setting and self-monitoring progress using exercise calendar; 4) develop a detailed exercise plan on how, what, when, and where to conduct exercise; 5) $10 rewards for exercising ≥30 mins per day for ≥5 of 7 days. The duration of this intervention is about 20 mins. |
| OG001 | Exercise Alone | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program, without cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. |
| OG002 | Attention Control Education Program | Participants will receive telephone-based education sessions from a study health professional. Attention control education program: A health care professional will call the participant weekly for a period of 8 weeks to teach general tips about exercise and diet (source: https://go4life.nia.nih.gov/). No recommendations for a specific exercise program will be made, except for walking 30 minutes daily or as tolerated. Each telephone session will cover 4 exercise tips and 4 healthy eating tips. The duration of the intervention is about 30 minutes. |
|
|
| Secondary | Change in the Short Physical Performance Battery (SPPB) Summary Score | The summary score is calculated based on chair stands, walking speed, and standing balance (range: 0-12). Higher scores indicate better physical performance. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | units on a scale | At baseline and week 8 |
|
|
|
| Secondary | Change in the 2-Minute Walk Distance (Feet) | The 2-minute walk distance measures endurance. A longer distance indicates better endurance. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | feet | At baseline and week 8 |
|
|
|
| Secondary | Change in Dominant Hand Grip Strength (kg) | Dominant hand grip strength measures upper extremity strength. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | kg | At baseline and week 8 |
|
|
|
| Secondary | Number of Participants Who Experienced Adverse Events | Number of participants who experience any adverse events and serious adverse events | Posted | Count of Participants | Participants | At week 8 |
|
|
|
| Other Pre-specified | Change in Mini-Mental State Examination (MMSE) Score | MMSE is an instrument that assesses general cognitive function (range: 0 to 30). Higher scores indicate better cognitive function. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | units on a scale | At baseline and week 8 |
|
|
|
| Other Pre-specified | Change in New York Heart Association (NYHA) Functional Class | NYHA assesses the extent of physical activity limitation due to heart failure. It ranges from 1 (ordinary physical activity does not cause symptoms) to 4 (symptoms occur at rest). | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | units on a scale | At baseline and week 8 |
|
|
|
| Other Pre-specified | Change in the Self-Efficacy Scale for Exercise (SEE) | The SEE scale measures self-efficacy about exercise (range: 0-90). Higher values indicate higher self efficacy. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | units on a scale | At baseline and week 8 |
|
|
|
| Other Pre-specified | Change in the Outcome Expectation Scale for Exercise (OEE) | The OEE scale measures outcome expectation about exercise (range: 9-45). Higher scores indicate higher expectation. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | units on a scale | At baseline and week 8 |
|
|
|
| Other Pre-specified | Adherence to the Home-based Exercise Program | The proportion of days with completed daily task during the entire study period will be measured. | Not Posted | At week 8 | Participants |
| Post-Hoc | Disability Score | The disability score measures the count of 22 daily activities and physical tasks that a person cannot perform without another person's help. It ranges from 0 to 22. Higher values indicate severe disability. Its correlation with LLFDI was -0.76 against the Activity Limitation Domain score and -0.65 against the Participation Restriction Domain score. | Participants with available data were analyzed. | Posted | Least Squares Mean | Standard Error | units on a scale | At baseline and week 8 |
|
|
|
| 0 |
| 18 |
| 1 |
| 18 |
| 12 |
| 18 |
| EG001 | Exercise Alone | A physical therapist will make home visits, beginning within 1 week of discharge, to deliver an individualized exercise program, without cognitive behavioral interventions. Exercise: Exercises will target balance, flexibility, strength, and endurance (source: https://go4life.nia.nih.gov/). Home visits will take place twice a week for week 1 and 2; once a week for week 3 and 4; every other week for week for week 5 through week 8. Participants are instructed to do prescribed exercises for 30 minutes daily. The duration of this intervention is about 40 mins. | 0 | 15 | 2 | 15 | 8 | 15 |
| EG002 | Attention Control Education Program | Participants will receive telephone-based education sessions from a study health professional. Attention control education program: A health care professional will call the participant weekly for a period of 8 weeks to teach general tips about exercise and diet (source: https://go4life.nia.nih.gov/). No recommendations for a specific exercise program will be made, except for walking 30 minutes daily or as tolerated. Each telephone session will cover 4 exercise tips and 4 healthy eating tips. The duration of the intervention is about 30 minutes. | 0 | 18 | 1 | 18 | 8 | 18 |
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | Systematic Assessment |
|
| Hallucination | Psychiatric disorders | Non-systematic Assessment |
|
| Heart failure | Cardiac disorders | Systematic Assessment |
|
| Epistaxis | Blood and lymphatic system disorders | Non-systematic Assessment |
|
| Seizure | Nervous system disorders | Non-systematic Assessment |
|
| Chest pain | Cardiac disorders | Systematic Assessment |
|
| Fatigue | General disorders | Systematic Assessment |
|
| Dizziness | Nervous system disorders | Systematic Assessment |
|
| Fall | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Abnormal blood test | Investigations | Non-systematic Assessment |
|
| Elevated blood pressure | Cardiac disorders | Systematic Assessment |
|
| Leg swelling | Cardiac disorders | Non-systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | Non-systematic Assessment |
|
| Angina | Cardiac disorders | Systematic Assessment |
|
| Arrhythmia | Cardiac disorders | Systematic Assessment |
|
| Cold intolerance | General disorders | Non-systematic Assessment |
|
| Confusion | Nervous system disorders | Non-systematic Assessment |
|
| Dehydration | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
|
| Dyskinesia | Nervous system disorders | Systematic Assessment |
|
| Dyspnea at rest | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Dyspnea on exertion | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Hallucination | Psychiatric disorders | Non-systematic Assessment |
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| Headache | Nervous system disorders | Non-systematic Assessment |
|
| Heart failure | Cardiac disorders | Systematic Assessment |
|
| Hypoglycemia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
|
| Epistaxis | Blood and lymphatic system disorders | Non-systematic Assessment |
|
| Palpitation | Cardiac disorders | Systematic Assessment |
|
| Seizure | Nervous system disorders | Non-systematic Assessment |
|
| Urinary tract infection | Infections and infestations | Non-systematic Assessment |
|
| Myocardial infarction | Cardiac disorders | Systematic Assessment |
|
| Stroke | Nervous system disorders | Systematic Assessment |
|
| Syncope | Nervous system disorders | Systematic Assessment |
|
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| D014694 |
| Ventricular Outflow Obstruction |
| D001519 | Behavior |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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