FLORENCE BLACKMAN I HUMAN CASE STUDY 66
YEARS OLD FEMALE DIAGONISED WITH CHEST PAIN 2
DIFFERENT VERSIONS (VERSION 1 AND VERSION 2)
NEWEST 2025 |GUARANTEED PASS A+ (FULL REVISED)
VERSION 1
Florence Blackman (66 y/o female) – Chest Pain
• CC: Intermittent squeezing chest pain
• MSAP: Exertional “squeezing” mid-chest pain radiating to left arm,
relieved by rest, worse with cold
• Associated dyspnea on exertion
• History: HLD, HTN, previous smoker, family hex of heart disease
• Stressful work
History Questions:
- How can I help you today?
- Any other symptoms we should discuss?
- Do you have any allergies?
- Are you taking any OTC or herbal medications?
- Any new or recent changes in medications?
- What does the pain / discomfort in your chest feel like? (squeezing,
pressure, crushing, burning, stabbing, aching, tingling, suffocating) -
How severe (scale 1-10) is the pain in your chest?
- Does anything make the pain in your chest better or worse?
- What are the events surrounding the start of your chest pain?
, - Is there a pattern to your chest pain?
- Have you had any trauma to your chest?
- Does the pain in your chest radiate someplace else? Where?
- Do you have unusual heartbeats (palpitations)?
- Does the pain get worse with breathing?
- Does your pain awaken you from your sleep?
- Is your pain affected by what, when, or how much you eat?
- Do you presently have heartburn, a food or acid taste in your mouth?
- Do you drink alcohol? If so, what do you drink and how many drinks
per day?
- Do you have any of the following problems: fatigue, difficulty sleeping,
unintentional weight loss or gain, fevers, night sweats?
- Do you experience: SOB, wheezing, difficulty catching breath, chronic
cough, sputum production?
- Does anything make your shortness of breath better or worse?
- How long does your SOB last?
- Do you have any of the following: heat or cold intolerance, increased
thirst, increased sweating, frequent urination, change in appetite?
- Do you have any of the following: dizziness, fainting, spinning room,
seizures, weakness, numbness, tingling, tremor?
- Do you have problems with: N/V, constipation, diarrhea, coffee
grounds in your vomit, dark tarry stool, bright red blood in your BM,
early satiety, bloating?
- How is your overall health?
- Tell me about your work.
- Tell me about daily exercise or sports that you play.
Physical Exam:
- Vitals: pulse, BP, respirations
- Examine skin
1
, - Neck: measure JVP (jugular venous pressure) - Neck: auscultate
carotid arteries - Chest wall & lungs:
o Visual inspection of anterior &
posterior chest o Palpate anterior & posterior chest
o Auscultate lungs - Heart:
o Palpate for PMI (Point of Maximal Impact) o
Auscultate heart - Abdomen:
o Auscultate abdominal/femoral
arteries o Palpate abdomen
- Extremities: Visual inspection of extremities
Assessment note:
- F.B. is a 66 y/o Caucasian female presenting with 2-week h/o new
onset, intermittent, stable chest pain which radiates to the L arm,
occurs with SOB, is worse with cold temperatures and exertion, and
improved by rest. On physical exam she is pain free with stable vital
signs. PMH risk factors include: distant history of smoking (5
pack/years), a history of HTN, and high cholesterol, and a family
history of coronary vascular disease.
- Stress test: 2-mm ST segment depression in inferior leads, 2, 3, and if
and V3-6 Diagnosis: Coronary artery disease: stable angina
Plan:
- Determine need for coronary angiography based on stress test results
and ECHO. Her Duke score of 10.5 is slightly above moderate risk, and
arguments could be made for both a trial at medication intervention
since the pt. needs improvement on both HTN and
HLD o Augment management of preexisting HTN and HLD with a BB
(metoprolol 25 mg XR daily); a statin (atorvastatin 40 mg daily); and ASA
2
YEARS OLD FEMALE DIAGONISED WITH CHEST PAIN 2
DIFFERENT VERSIONS (VERSION 1 AND VERSION 2)
NEWEST 2025 |GUARANTEED PASS A+ (FULL REVISED)
VERSION 1
Florence Blackman (66 y/o female) – Chest Pain
• CC: Intermittent squeezing chest pain
• MSAP: Exertional “squeezing” mid-chest pain radiating to left arm,
relieved by rest, worse with cold
• Associated dyspnea on exertion
• History: HLD, HTN, previous smoker, family hex of heart disease
• Stressful work
History Questions:
- How can I help you today?
- Any other symptoms we should discuss?
- Do you have any allergies?
- Are you taking any OTC or herbal medications?
- Any new or recent changes in medications?
- What does the pain / discomfort in your chest feel like? (squeezing,
pressure, crushing, burning, stabbing, aching, tingling, suffocating) -
How severe (scale 1-10) is the pain in your chest?
- Does anything make the pain in your chest better or worse?
- What are the events surrounding the start of your chest pain?
, - Is there a pattern to your chest pain?
- Have you had any trauma to your chest?
- Does the pain in your chest radiate someplace else? Where?
- Do you have unusual heartbeats (palpitations)?
- Does the pain get worse with breathing?
- Does your pain awaken you from your sleep?
- Is your pain affected by what, when, or how much you eat?
- Do you presently have heartburn, a food or acid taste in your mouth?
- Do you drink alcohol? If so, what do you drink and how many drinks
per day?
- Do you have any of the following problems: fatigue, difficulty sleeping,
unintentional weight loss or gain, fevers, night sweats?
- Do you experience: SOB, wheezing, difficulty catching breath, chronic
cough, sputum production?
- Does anything make your shortness of breath better or worse?
- How long does your SOB last?
- Do you have any of the following: heat or cold intolerance, increased
thirst, increased sweating, frequent urination, change in appetite?
- Do you have any of the following: dizziness, fainting, spinning room,
seizures, weakness, numbness, tingling, tremor?
- Do you have problems with: N/V, constipation, diarrhea, coffee
grounds in your vomit, dark tarry stool, bright red blood in your BM,
early satiety, bloating?
- How is your overall health?
- Tell me about your work.
- Tell me about daily exercise or sports that you play.
Physical Exam:
- Vitals: pulse, BP, respirations
- Examine skin
1
, - Neck: measure JVP (jugular venous pressure) - Neck: auscultate
carotid arteries - Chest wall & lungs:
o Visual inspection of anterior &
posterior chest o Palpate anterior & posterior chest
o Auscultate lungs - Heart:
o Palpate for PMI (Point of Maximal Impact) o
Auscultate heart - Abdomen:
o Auscultate abdominal/femoral
arteries o Palpate abdomen
- Extremities: Visual inspection of extremities
Assessment note:
- F.B. is a 66 y/o Caucasian female presenting with 2-week h/o new
onset, intermittent, stable chest pain which radiates to the L arm,
occurs with SOB, is worse with cold temperatures and exertion, and
improved by rest. On physical exam she is pain free with stable vital
signs. PMH risk factors include: distant history of smoking (5
pack/years), a history of HTN, and high cholesterol, and a family
history of coronary vascular disease.
- Stress test: 2-mm ST segment depression in inferior leads, 2, 3, and if
and V3-6 Diagnosis: Coronary artery disease: stable angina
Plan:
- Determine need for coronary angiography based on stress test results
and ECHO. Her Duke score of 10.5 is slightly above moderate risk, and
arguments could be made for both a trial at medication intervention
since the pt. needs improvement on both HTN and
HLD o Augment management of preexisting HTN and HLD with a BB
(metoprolol 25 mg XR daily); a statin (atorvastatin 40 mg daily); and ASA
2
