The CE provider will describe and discuss, as appropriate:

a. Dyspnea and/or orthopnea;

b. Fatigue and/or exercise intolerance;

c. Hypercyanotic spells;

d. Palpitations, lightheadedness, syncope, and/or near syncope;

e. Use of mechanical circulatory support device;

f. Slow feeding, gastrointestinal distress, or growth failure; and

g. Dates and results of any relevant diagnostic procedures, such as cardiac magnetic resonance imaging, chest x-ray, echocardiography, radionuclide studies, cardiac catheterization, angiography, or exercise tolerance tests.

The CE provider will describe and discuss, as appropriate:

1. a. 

   Respiratory rate and whether respirations are labored;

2. b. 

   Evidence of hypoxemia, such as cyanosis, clubbing, or pallor;

3. c. 

   Breath sounds, including evidence of wheezing and rales;

4. d. 

   Blood oxygen saturation (SpO₂);

5. e. 

   Heart sounds and murmurs;

6. f. 

   Apical heart rate;

7. g. 

   Presence of hepatomegaly, ascites, and/or edema; and

8. h. 

   Exercise tolerance test (ETT). The CE provider will obtain ETT only after receiving proper authorization from DDS. Use ETT only for children age 6 and older, and perform as specified in section 104.00B7 of the cardiovascular listing (see DI 34005.104).