Year-Old Female with Exertional Chest Pain in an Outpatient Clinic Leading to a
Diagnosis of Stable Angina Pectoris 2026-2027
,i-Human Case Study – Week 4, Class 6531: Expert Analysis of a 69-Year-Old
Female with Exertional Chest Pain in an Outpatient Clinic Leading to a
Diagnosis of Stable Angina PectorisPatient Demographics
Name: Mei Yang (Simulated i-Human Patient)
Age: 69 years
Sex: Female
Chief Complaint: Exertional chest pain
Setting: Outpatient Primary Care Clinic equipped with ECG, X-ray, and
laboratory capabilities
Occupation: Retired teacher
Social History Overview: Former smoker (20 pack-years; quit 10 years ago);
sedentary lifestyle; diet high in saturated fats; no alcohol or illicit drug use;
lives with spouse and is independent in activities of daily living (ADLs)
History of Present Illness (HPI)The patient is a 69-year-old female presenting
with intermittent exertional chest pain that began approximately 4 months
, ago. The pain is characterized as a pressure-like, squeezing sensation,
tightness, or heaviness, located substernally or mid-sternally. It is rated 6/10
in intensity at its worst and occasionally radiates to the left shoulder and jaw.
Episodes are triggered by physical exertion, such as brisk walking, walking
uphill, climbing stairs, or carrying groceries, and sometimes by stress. The
pain onset is gradual, lasts 5–10 minutes, and resolves with rest. It occurs a
few times per week and has remained stable in frequency and intensity.
Associated symptoms include mild shortness of breath (dyspnea) and mild
diaphoresis during episodes, but no nausea, vomiting, syncope, palpitations,
or pleuritic pain. There is no chest pain at rest, no recent trauma, respiratory
infection, fever, or gastrointestinal symptoms. The patient has not sought
prior medical care for this issue.Using the OPQRST framework:
Onset: Gradual, during exertion
Provocation/Palliation: Provoked by activity/stress; palliated by rest
Quality: Pressure, tightness, heaviness
Region/Radiation: Substernal; radiates to left shoulder/jaw