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John Quimby is a 45-year-old male presenting with acute onset severe chest pain that began suddenly while lifting heavy boxes at work and radiates to his jaw and left arm. I

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John Quimby is a 45-year-old male presenting with acute onset severe chest pain that began suddenly while lifting heavy boxes at work and radiates to his jaw and left arm. I

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2025/2026
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John Quimby iHuman Case Study 2025
John Quimby is a 45-year-old male presenting with acute onset severe chest pain that
began suddenly while lifting heavy boxes at work and radiates to his jaw and left arm. In
this comprehensive guide, we’ll walk you through how to approach his case, from initial
history-taking through physical examination to the final diagnosis of acute myocardial
infarction. You’ll learn the key clinical reasoning steps, what the iHuman grading rubric
expects, and a complete step-by-step solution to help you confidently navigate this
acute cardiovascular emergency simulation.

,
, John Quimby iHuman Case Overview (Doorway
Information)
Patient Overview: John Quimby is a 45-year-old African American male presenting
with a chief complaint of “severe crushing chest pain” that began suddenly 2 hours ago
while lifting heavy equipment at his construction job. He describes experiencing acute
onset substernal chest pain with a “crushing, elephant sitting on my chest” sensation
that radiates to his jaw and left arm. The pain is associated with diaphoresis, nausea,
and shortness of breath and has not improved with rest.

Key Background Information:

• Age/Gender: 45-year-old male
• Chief Complaint: Severe crushing chest pain
• Duration: 2 hours since onset
• Pain Characteristics: Sudden onset, substernal, crushing, radiates to jaw and left
arm, no relief with rest
• Associated Symptoms: Diaphoresis, nausea, shortness of breath
• Significant History: Type 2 diabetes mellitus, smoking (1 pack per day for 25
years), family history of early coronary artery disease
• Current Medications: Metformin 1000mg twice daily
• Occupation: Construction worker with physically demanding job
• Lifestyle: Sedentary outside of work, poor diet, high stress levels, active smoker

The patient appears pale and diaphoretic, in obvious distress, with elevated vital signs.
His presentation is classic for acute coronary syndrome, making this an excellent case
for learning emergency cardiovascular assessment and acute MI management skills.

John Quimby (45 y/o male) – Acute Chest Pain
Assessment
Chief Complaint: Severe crushing chest pain

Most Significant Active Problem (MSAP): Acute onset “crushing” substernal chest
pain radiating to jaw and left arm, unrelieved by rest

• Sudden onset while lifting heavy equipment
• Associated diaphoresis, nausea, and dyspnea
• History: T2DM, smoking history, family hx of early CAD
• High-stress occupation
History Questions:

Essential questions to ask during the iHuman case:
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