| 1. | Have you ever had any pain or discomfort in your chest? |
| 2. | Do you get it when you walk uphill or hurry? |
| 3. | Do you get it when you walk at an ordinary pace on level ground? |
| 4. | What do you do if you get it while you are walking? |
| 5. | Do you stop or slow down or continue at the same pace? |
| 6. | If you stand still, what happens to it? |
| 7. | Is the pain or discomfort relieved or not relieved? |
| 8. | How soon is the pain relieved? |
| 9. | Where is the pain or discomfort located? |