Your doctor has prescribed a heart monitor for you in an effort to record your hearts electrical activity while you go about your daily routine.

In this record, please record as closely as possible the time of the following activities:
 

• taking of medications
• change in activity
• meal times
• emotional upsets
• any events which produce symptoms such as dizziness, pain, shortness of breath, etc.

In addition, if you experience any events which produce symptoms such as dizziness, pain, shortness of breath, etc., PRESS THE BLUE BUTTON ON THE MONITOR.

If these symptoms are unusual or are not relieved with appropriate intervention as prescribed by your physician or you are concerned, SEEK APPROPRIATE MEDICAL ATTENTION.

Please indicate the exact time of day that any symptoms occur and include the circumstances associated with the symptoms.

You are required to return to Cardio/ Respiratory Services on to have the recorder removed. Bring this record with you.

Medications: Document the name of the drug(s), the dosage, and when you took it for the duration of the test.