Table 2

Screening pro forma suitable for use in screening examinations

NameTelephone number
Personal historyPrevious myocardial infarction/angina of effort/peripheral arterial disease/cerebral infarction
Family historyAngina or heart attack in:
 mother/sister aged < 65 years
 father/brother aged < 55 years
Smoking habit
Length of exposureYears
Other tobacco
Diabetes mellitusYes/no
Age at menopauseYears
Body weightkgHeightcm
Blood pressureSystolicmm Hg
(treated hypertension yes/no)Diastolicmm Hg
Other xanthomata (eg, tendon)Yes/no
Corneal arcus in patient aged < 50 yearsYes/no
HDL cholesterolmmol/l
Date of last tetanus booster
Date of last cervical smear
  • NB If angina is diagnosed for the first time the screening nurse should refer the patient to the doctor. Referral to a cardiologist for full evaluation may be important because further investigation may be indicated on prognostic grounds even if symptoms are not severe. Of more immediate concern is lifestyle advice, control of blood pressure, blood cholesterol, and diabetes mellitus, and therapy with low dose aspirin.