Case Week #2: Outpatient Evaluation of Recurrent Chest Pain in a 69-Year-Old
Female (Mei Yang) – Comprehensive Cardiometabolic Assessment and Follow-Up
(2025)"
, CASE WEEK #2: MEI YANG
• Age/Sex: 69-year-old female
• Height: 5'3" (160 cm)
• Weight: 167.0 lb (75.9 kg)
• BMI: ≈29.5 (Overweight)
• Reason for Encounter: Chest Pain Recheck
• Visit Type: Follow-up
Chief Complaint
“Follow-up for chest pain I had last week.”
History of Present Illness (HPI)
Ms. Mei Yang returns for a recheck after experiencing chest pain during the prior week. She
describes the pain as:
• Location: Central chest, non-radiating
• Character: Pressure-like, not sharp
• Severity: 4/10 during episode
• Duration: Lasted about 15–20 minutes
• Onset: Gradual
, • Alleviating Factors: Rest
• Aggravating Factors: Mild exertion (walking uphill)
• Associated Symptoms: Mild shortness of breath; no nausea, diaphoresis, dizziness,
or palpitations
She reports no recurrence of chest pain since the episode but remains concerned and is
here for further evaluation.
Past Medical History
• Hypertension
• Hyperlipidemia
• Type 2 Diabetes Mellitus
• Osteoarthritis
• GERD (gastroesophageal reflux disease)
• No history of MI, CAD, or heart failure documented
Medications
• Metformin 500 mg BID
• Lisinopril 10 mg daily
• Atorvastatin 20 mg nightly
• Omeprazole 20 mg daily
• Acetaminophen PRN for joint pain
, Family History
• Father: Died of heart disease at 72
• Mother: Type 2 Diabetes, died at 80 from stroke
• Siblings: Brother with HTN and hyperlipidemia
Social History
• Former smoker: quit 15 years ago (15 pack-year history)
• Rare alcohol use
• No recreational drug use
• Retired; lives with husband; moderate physical activity
Review of Systems (ROS)
• Cardiac: No current chest pain, palpitations, or syncope
• Respiratory: No cough or dyspnea at rest
• GI: Occasional heartburn
• Neuro: No dizziness or focal weakness
• Musculoskeletal: Mild joint pain
Physical Exam
• General: Well-appearing, no acute distress
• BP: 138/82 mmHg
Female (Mei Yang) – Comprehensive Cardiometabolic Assessment and Follow-Up
(2025)"
, CASE WEEK #2: MEI YANG
• Age/Sex: 69-year-old female
• Height: 5'3" (160 cm)
• Weight: 167.0 lb (75.9 kg)
• BMI: ≈29.5 (Overweight)
• Reason for Encounter: Chest Pain Recheck
• Visit Type: Follow-up
Chief Complaint
“Follow-up for chest pain I had last week.”
History of Present Illness (HPI)
Ms. Mei Yang returns for a recheck after experiencing chest pain during the prior week. She
describes the pain as:
• Location: Central chest, non-radiating
• Character: Pressure-like, not sharp
• Severity: 4/10 during episode
• Duration: Lasted about 15–20 minutes
• Onset: Gradual
, • Alleviating Factors: Rest
• Aggravating Factors: Mild exertion (walking uphill)
• Associated Symptoms: Mild shortness of breath; no nausea, diaphoresis, dizziness,
or palpitations
She reports no recurrence of chest pain since the episode but remains concerned and is
here for further evaluation.
Past Medical History
• Hypertension
• Hyperlipidemia
• Type 2 Diabetes Mellitus
• Osteoarthritis
• GERD (gastroesophageal reflux disease)
• No history of MI, CAD, or heart failure documented
Medications
• Metformin 500 mg BID
• Lisinopril 10 mg daily
• Atorvastatin 20 mg nightly
• Omeprazole 20 mg daily
• Acetaminophen PRN for joint pain
, Family History
• Father: Died of heart disease at 72
• Mother: Type 2 Diabetes, died at 80 from stroke
• Siblings: Brother with HTN and hyperlipidemia
Social History
• Former smoker: quit 15 years ago (15 pack-year history)
• Rare alcohol use
• No recreational drug use
• Retired; lives with husband; moderate physical activity
Review of Systems (ROS)
• Cardiac: No current chest pain, palpitations, or syncope
• Respiratory: No cough or dyspnea at rest
• GI: Occasional heartburn
• Neuro: No dizziness or focal weakness
• Musculoskeletal: Mild joint pain
Physical Exam
• General: Well-appearing, no acute distress
• BP: 138/82 mmHg
