Lesson 1Targeted review of systems to differentiate cardiac, pulmonary, GI, musculoskeletal causesPractise a focused systems review to separate heart from lung, stomach, or muscle issues, using key questions that narrow options fast without slowing urgent help.
Cardiac ROS for ischemia and pericarditisPulmonary ROS for PE and pneumothoraxGastrointestinal ROS for reflux and ulcerMusculoskeletal and chest wall questionsPrior similar episodes and chronicityLesson 2Open-ended and presenting complaint questions (onset, character, radiation, severity, duration)Learn to start chats openly, then pinpoint start time, feel, spread, strength, and length of pain. Focus on fair questioning, timelines, and proper pain rating.
Building rapport and opening the interviewUsing open-ended questions for chest painClarifying onset and temporal patternCharacter, location, and radiation of painSeverity scales and impact on functionLesson 3Associated symptoms (dyspnea, diaphoresis, nausea, syncope, palpitations)Systematically check for shortness of breath, sweating, sickness, fainting, and irregular beats, spotting symptom mixes pointing to heart attacks, rhythm issues, or others.
Characterizing dyspnea and orthopneaDiaphoresis and autonomic activationNausea, vomiting, and epigastric painSyncope, presyncope, and red flagsPalpitations and arrhythmia cluesLesson 4Social history and substance use (smoking quantity, alcohol, recreational drugs, occupational, recent travel)Explore smoking amounts, drink, party drugs, job, and recent trips. Link these to heart risks, lung clots, and other pain sources.
Quantifying tobacco exposure in pack-yearsAlcohol intake and cardiomyopathy riskCocaine and stimulant-associated ischemiaOccupational and environmental exposuresTravel history and venous thromboembolismLesson 5Family history of premature cardiovascular disease or sudden deathIdentify family details that raise risks, ask about early heart disease or sudden passing, and record ages, conditions, and links clearly with care.
Defining premature cardiovascular diseaseKey questions about sudden cardiac deathDocumenting affected relatives and agesHereditary lipid and cardiomyopathy cluesHandling sensitive family discussionsLesson 6Recent infections, trauma, or surgeries and thromboembolic risk factors (immobility, cancer, estrogen use)Connect recent bugs, injuries, or ops to pain causes, spotting clot risks like no movement, cancer, or hormone pills that hint at lung clots.
Recent respiratory or systemic infectionsChest trauma and musculoskeletal injuryPostoperative and immobilization risksCancer, estrogen, and thrombophilia historyWhen to suspect pulmonary embolismLesson 7Provoking/relieving factors and timing (exertion, position, meals, respiration)See how effort, posture, food, or breathing change pain. Tell apart heart squeeze, heart sac inflammation, acid reflux, or lung lining pain by triggers, relief, and daily patterns.
Exertional angina and demand ischemiaPositional clues to pericardial diseaseMeal-related and reflux-associated painRespiratory and pleuritic pain patternsNocturnal and rest pain red flagsLesson 8Past medical history and cardiovascular risk factors (hypertension, hyperlipidemia, diabetes, prior coronary disease)Gather old health info and heart risks like high blood pressure, high fats, sugar sickness, past heart issues, and how they shift odds and speed needs.
Documenting prior coronary eventsHypertension and end-organ damage historyHyperlipidemia and treatment adherenceDiabetes, kidney disease, and riskOther vascular and stroke historyLesson 9Medication, allergy, and anticoagulation history (current meds, aspirin/statin use, allergies)Get exact drug lists, including shop buys, blood thinners, fat pills, and clot stoppers, plus allergies key to chest pain handling.
Verifying current prescription medicationsOver-the-counter and herbal productsAntiplatelet, statin, and anticoagulant useClarifying true drug allergies vs side effectsImplications for acute chest pain therapyLesson 10How to document and phrase questions clearly and compassionately for exam reports and handoversPhrase questions simply, skip jargon, keep kindness. Practise note structure, key yes/no points, short reports, and safe shift handovers.
Using patient-centered, nonjudgmental languageStructuring focused chest pain questionsSummarizing key positives and negativesWriting concise exam notes and reportsSafe, structured handover communication
