(CLASS 6531) LOCATION; OUTPATIENT CLINIC WITH X-RAY, ECG, AND
LABARATORY CAPABILITIES.LATEST EXAM
covering all necessary aspects, including the Chief
Complaint (CC), History of Present Illness (HPI), Physical
Exam (PE), Differential Diagnosis (DDx), Laboratory Tests,
and Management Plan.
, Step-by-Step Evaluation for a 69-Year-Old with Chest Pain
Chief Complaint (CC)
CC: Chest pain.
History of Present Illness (HPI)
1. Onset
o Clinician: "Can you tell me when the chest pain started?"
o Patient: "It began about two weeks ago."
Explanation: Establishing onset helps determine whether the condition is acute or
chronic. Chest pain of recent onset could suggest ischemia (e.g., myocardial
infarction) or other acute causes, while chronic pain might indicate conditions like
angina or musculoskeletal pain.
2. Character of the Pain
o Clinician: "How would you describe the pain? Is it sharp, dull,
pressure-like?"
o Patient: "It feels like pressure, tightness in the middle of my chest."
Explanation: Chest pressure or tightness is concerning for cardiac causes like
angina or myocardial infarction. A sharp or stabbing pain could point to pleuritic
causes or musculoskeletal issues.