Anamnese

Cough

Yes No

Shortness of breath

Yes No

Wheezing (whistling breathing)

Yes No

Chest pain

Yes No

Dizziness

Yes No

Sarcoidosis

Yes No

Chronic bronchitis or asthma

Yes No

COPD / pulmonary emphysema

Yes No

Tuberculosis

Yes No

Allergies (e.g., to dust, animal hair, pollen)

Yes No

Are you regularly exposed to dust, fumes, or smoke?

Yes No

Do you take medication regularly?

Yes No

“Have you had pneumonia in the past 12 months?

Yes No

“Do you suffer from high blood pressure or heart rhythm disorders?

Yes No

Have you had heart attacks, heart surgery, or any other heart diseases?

Yes No

Are you a smoker?

Yes No

Asthma or other chronic lung diseases

Yes No

Allergies

Yes No