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Pregnant or breastfeeding women are also advised against taking lipotropic injections, as the safety of these treatments during pregnancy and lactation has not been conclusively established

Objective strength findings, functional limitation, symptom duration/progression, assessment, and a plan tied to measurable deficits

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6 Relevant guidelines 2018 American College of Cardiology/American Heart Association Scientific Statement/ Heart Rhythm Society In patients with symptomatic chronotropic incompetence, permanent pacing with rate-responsive programming is reasonable to increase exertional heart rates and improve symptoms

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