Chest Pain - OSCE history taking for Medical Students | Drs Manual

The Doctors Manual
19 Oct 201909:40

Summary

TLDRIn the provided transcript, a 55-year-old patient recounts experiencing severe chest pain that prompted an emergency hospital visit. The pain, described as a pressure and lasting 40 minutes, was alleviated by ambulance-administered painkillers. The patient expresses concern, recalling his father's similar symptoms leading to a heart bypass surgery. The medical team discusses potential causes, rules out some differential diagnoses, and plans further investigations to determine the cause of the chest pain.

Takeaways

  • 👤 The patient is a 55-year-old male who was experiencing severe chest pain and was brought to the hospital by an ambulance.
  • 🚑 The chest pain episode lasted approximately 40 minutes and was the first time the patient had experienced such pain.
  • 💔 The pain was described as a pressure on the chest, moving to the arm and neck, and was constant throughout the 40-minute period.
  • 🆘 The patient rated the pain as severe, between 8 and 9 on a scale of zero to ten, with ten being the worst.
  • 💊 The patient was given painkillers by the ambulance, which provided some relief.
  • 🤔 The patient is concerned about the possibility of a heart attack, as his father had a similar experience at the same age and required bypass surgery.
  • 🏥 The patient has a history of high blood pressure and is currently on medication (Ramipril), but readings have been high recently.
  • 🍽 The patient experiences heartburn and takes Gaviscon for it, but the chest pain felt different from the usual heartburn.
  • 🚭 The patient has been smoking for 25 years, about half a pack a day.
  • 🥃 The patient drinks alcohol occasionally, mainly on weekends, with one or two glasses of wine.
  • 🏠 The patient's family history includes heart problems (father's heart attack) and diabetes (mother's condition).

Q & A

  • What was the patient's main complaint?

    -The patient experienced severe chest pain that started suddenly in the morning and lasted for about 40 minutes.

  • How did the patient describe the chest pain?

    -The patient described the chest pain as feeling like someone sitting on his chest, a pressure or a crushing sensation.

  • Did the chest pain radiate to other areas?

    -Yes, the pain radiated to the patient's arm and neck, but did not move to the back.

  • How long did the chest pain last before the patient was taken to the hospital?

    -The chest pain lasted for about 40 minutes before the ambulance arrived and administered painkillers.

  • What was the patient's initial reaction to the painkillers?

    -The patient reported that the painkillers helped quite a bit in alleviating the chest pain.

  • Has the patient experienced similar chest pain before?

    -No, this was the first time the patient had experienced chest pain of this nature.

  • What was the patient's family history of heart conditions?

    -The patient's father had a heart attack at around the same age and had to undergo bypass surgery.

  • What other health conditions does the patient have?

    -The patient has high blood pressure and high cholesterol, for which he takes ramipril, a statin, and gaviscon for heartburn.

  • Does the patient have any lifestyle habits that could impact his health?

    -The patient smokes about half a pack of cigarettes a day and drinks alcohol occasionally on weekends.

  • What was the patient's level of concern regarding the chest pain?

    -The patient was quite worried about the chest pain, especially considering his father's history of a heart attack.

  • What was the patient's occupation and did his work know about his current health situation?

    -The patient is currently working and his workplace is aware of his health situation, offering him time off as needed.

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Ähnliche Tags
Chest PainMedical InterviewHealth ConcernsEmergency CarePatient NarrativeHeart AttackAmbulancePain DescriptionHealth ConsultationFamily History
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