Coronary Artery Disease (CAD) Patient Tracking Log

Patient Information

Name: ___________________ Date: //___ Physician: _______________ Next Appointment: //___

Daily Vital Signs

Medication Log

• Morning Medications: □ Taken □ Missed
• Evening Medications: □ Taken □ Missed
• Notes: ______________________________

Physical Activity

• Duration: ___ minutes
• Type: □ Walking □ Swimming □ Other: _______
• Intensity (1-10): ___
• Any chest pain during activity? □ Yes □ No

Angina Episodes

• Number of episodes today: ___
• Nitroglycerin used: □ Yes □ No
• Time of episodes: __________________
• Triggers: _________________________

Diet Tracking

• Sodium intake monitored? □ Yes □ No
• Water intake (cups): ___
• Followed heart-healthy diet? □ Yes □ No

Weekly Summary

Blood pressure range: / Weight change: ___ Total exercise minutes: ___

Emergency Contacts

Cardiologist: ________________ Emergency number: ___________

*Contact your healthcare provider immediately if you experience:

• Chest pain lasting >5 minutes
• Shortness of breath at rest
• Severe dizziness
• Rapid or irregular heartbeat*