BURNING CHEST DISCOMFORT A
CASE STUDY ON DIFFERENTIAL
DIAGNOSIS IN A 58-YEAR-OLD MALE
EXAM UPDATE 2026
iHuman Case Study: Jacob Abraham
Chief Complaint: "I have this burning feeling in my chest."
Patient Bio Data
• Name: Jacob Abraham
• Age: 58 years old
• Gender: Male
• Ethnicity: Caucasian
• Primary Language: English
• Occupation: Accountant
• Code Status: Full Code
• Source: Patient (reliable)
History of Present Illness (HPI)
, Jacob Abraham is a 58-year-old male who presents to the clinic
complaining of a burning discomfort in his central chest. He states
the sensation began approximately 3 hours ago, shortly after
eating a large, spicy meal for lunch. He describes the pain as a
persistent burning feeling located substernally, rating it a 4/10 in
intensity. He denies any radiation of the pain to his jaw, back, or
arms.
The patient reports that he has had similar but milder episodes in
the past, typically after overeating or consuming spicy foods. He
has never sought medical attention for these previous episodes.
Today's discomfort is more pronounced and has not resolved with
sitting up. He took an over-the-counter antacid (Tums) about an
hour ago, which provided minimal relief.
Aggravating Factors: Lying flat, large meals, spicy foods.
Relieving Factors: Sitting upright (partial relief), antacids
(minimal relief today).
Review of Systems (ROS)
• General: Denies fever, chills, recent weight loss, or fatigue.
• Cardiovascular: Denies palpitations, syncope, or lower
extremity edema. Chest discomfort as described in HPI.
• Respiratory: Denies shortness of breath, cough, or
wheezing.
• Gastrointestinal: Reports the burning chest discomfort and
a sensation of regurgitation. Denies nausea, vomiting,
dysphagia (difficulty swallowing), odynophagia (painful
CASE STUDY ON DIFFERENTIAL
DIAGNOSIS IN A 58-YEAR-OLD MALE
EXAM UPDATE 2026
iHuman Case Study: Jacob Abraham
Chief Complaint: "I have this burning feeling in my chest."
Patient Bio Data
• Name: Jacob Abraham
• Age: 58 years old
• Gender: Male
• Ethnicity: Caucasian
• Primary Language: English
• Occupation: Accountant
• Code Status: Full Code
• Source: Patient (reliable)
History of Present Illness (HPI)
, Jacob Abraham is a 58-year-old male who presents to the clinic
complaining of a burning discomfort in his central chest. He states
the sensation began approximately 3 hours ago, shortly after
eating a large, spicy meal for lunch. He describes the pain as a
persistent burning feeling located substernally, rating it a 4/10 in
intensity. He denies any radiation of the pain to his jaw, back, or
arms.
The patient reports that he has had similar but milder episodes in
the past, typically after overeating or consuming spicy foods. He
has never sought medical attention for these previous episodes.
Today's discomfort is more pronounced and has not resolved with
sitting up. He took an over-the-counter antacid (Tums) about an
hour ago, which provided minimal relief.
Aggravating Factors: Lying flat, large meals, spicy foods.
Relieving Factors: Sitting upright (partial relief), antacids
(minimal relief today).
Review of Systems (ROS)
• General: Denies fever, chills, recent weight loss, or fatigue.
• Cardiovascular: Denies palpitations, syncope, or lower
extremity edema. Chest discomfort as described in HPI.
• Respiratory: Denies shortness of breath, cough, or
wheezing.
• Gastrointestinal: Reports the burning chest discomfort and
a sensation of regurgitation. Denies nausea, vomiting,
dysphagia (difficulty swallowing), odynophagia (painful
