The doctor asked the patient if she had had a heart attack before. The doctor asked the patient,” _______ a heart attack before ?” ?

The correct choice is C: "Did she have." This option is appropriate because it maintains the correct tense and perspective in reporting a question. When a doctor asks the patient about her medical history, the inquiry is directed towards her past experiences. Since the doctor is already speaking in the past tense ("asked"), the reported speech requires the verb to follow suit in both tense and perspective.

When transforming a direct question into reported speech, the pronouns and verb tenses often change. In this case, if the original question were framed as “Did you have a heart attack before?” the first-person perspective shifts to third-person in the reporting. Thus, “you” becomes “she,” which reflects the patient’s point of view.

Options A (“Has she had”) and B (“Have you had”) do not fit because they suggest a present perfect tense, which is not suitable for this context where the doctor is referencing a specific past event. Option D (“Did you have”) also maintains the first-person perspective, which does not align with reported speech for the context. Hence, C: “Did she have” appropriately reflects both the time and perspective required in the reported question.