Are you or a loved one

at risk of heart valve disease?

Take the questionnaire

It’s not always easy to tell if you or a loved one has heart valve disease (HVD). There aren’t always symptoms and if there are, they can be subtle. But, if you know what to look for, you’re one step closer to getting answers.

Take a few minutes to answer the questions below and get a personalized discussion guide to talk with your doctor about HVD.

Hi, are you taking this for you or someone else?

1

Please select an option.

Age

2

How old are you?

Please select an option.

Family history

3

Does your family have a history of heart conditions?

Please select an option.

Murmur

4

Have you been checked for an abnormal heart murmur?

Please select an option.

Echocardiogram

5

Have you ever had an echocardiogram, a simple heart ultrasound?

Please select an option.

Activity level

6

Compared to 6 months ago, do you still do daily activities and hobbies you’ve always enjoyed? (long walks, golf, cooking, time with family/friends, going to the store, etc.)

Please select an option.

Signs/Symptoms

7

Which of the below sound like you?

Please select an option.

Progress

0 of 7 questions completed

Hi, are you taking this for you or someone else?

1

Please select an option.

Age

2

How old are they?

Please select an option.

Family history

3

Do they have a family history of heart conditions?

Please select an option.

Murmur

4

Have they been checked for an abnormal heart murmur?

Please select an option.

Echocardiogram

5

Have they ever had an echocardiogram, a simple heart ultrasound?

Please select an option.

Activity level

6

Compared to 6 months ago, does it seem like they're avoiding their daily activities and hobbies they’ve always enjoyed? (long walks, golf, cooking, time with family/friends, going to the store, etc.)

Please select an option.

Signs/Symptoms

7

Which of the below sound like them?

Please select an option.

Progress

0 of 7 questions completed

Next Section

How do I talk to my doctor about my symptoms?