Lesson 1Targeted review of systems to differentiate cardiac, pulmonary, GI, musculoskeletal causesPractise pinpointing systems review to separate heart from lung, stomach, or muscle pain causes, using key questions that narrow options fast without slowing emergency care in our resource-limited setups.
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 probe start time, feel, spread, strength, and length of pain. Focus on fair questioning, timelines, and proper pain rating for accurate notes.
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)Master asking about shortness of breath, sweating, vomiting urge, fainting, and irregular beats, spotting combos hinting at heart attacks, rhythm issues, or other chest pain sources.
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)Dive into smoking packs, booze, street drugs, job hazards, and fresh trips. Link these to heart risks, lung clots, and common chest pains seen in our communities.
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 risks that boost danger, ask sensitively about early heart issues or quick deaths, and record ages, conditions, and kin ties clearly for full pictures.
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 fresh bugs, injuries, or ops to chest pains, spotting clot risks like bed rest, tumours, or birth control pills that flag lung clots in urgent cases.
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 work, pose, food, or breaths change chest pain. Tell apart heart squeeze, heart sack inflammation, acid reflux, or lung lining pain via triggers 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)Pull out old illnesses and heart risks like high blood pressure, high fats, sugar sickness, past blockages, and how they shift odds and speed in busy clinics.
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, noting allergies key to sharp chest pain handling in our wards.
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 handoversCraft clear, jargon-free questions with kindness. Practise neat notes, key yes/no points, short reports, and safe shift handovers for team continuity.
Using patient-centered, nonjudgmental languageStructuring focused chest pain questionsSummarizing key positives and negativesWriting concise exam notes and reportsSafe, structured handover communication
