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history taking : Chest pain

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steps to take history of chest pain
with presented case

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history taking : Chest pain

  1. 1. HISTORY TAKING: CHEST PAIN
  2. 2. OBJECTIVES OF HISTORY TAKING      To make a DD or Dx Ta assess FUNCTIONAL CAPACITY To establish a meaningful Dr Pt rapport To develop a problem list To assess socio-economic status and preferences
  3. 3. OVERVIEW OF HISTORY CHIEF COMLPLAINT  HISTORY OF PRESENT ILLNESS  PAST HISTORY  FAMILY HISTORY  SOCAIL HISTORY  DRUG HISTORY  REVIEW OF SYSTEMS 
  4. 4. PRESENTING COMPLIANT Mr. Aslam 50 year old ,male , labourer by profession, resident of peoples colony presented in emergency on 15 December with the CHIEF COMPLAINT of chest pain for 4 hours 
  5. 5. What diagnosis comes in your mind?
  6. 6. DIFFERENTIAL DIAGNOSIS Cardiac cause  Respiratory cause  Musculoskeletal cause  GI and Mediastnal causes 
  7. 7. DIFFERENTIAL DIAGNOSIS  • • • • CARDIACAngina Myocardial infarction Pericarditis Myocarditis
  8. 8.  • • • • RESPIRATORYPneumothorax Pulmonary embolism Tracheitis Pleuritis
  9. 9.  • • • • GI AND MEDIASTNALAortic dissection or aneurysm Esophagitis Esophageal rupture Esophageal spasm
  10. 10.  • • • • • MUSCULOSKELETALSoft tissue and bone injury Osteochondritis Osteoarthritis Herpes zoster REFERRED PAIN
  11. 11. HISTORY OF PRESENT ILLNESS When was the patient well last? 2 months ago 1. SETTING(Onset):pain was SUDDEN when patient woke up in the morning 2. INTENSITY: pain was SEVERE
  12. 12. 3. SITE AND RADIATION: pain was CENTRAL, radiating to left arm and jaw 4. DURATION: from last four hours
  13. 13. 5. 6. CHARACTER: pain was CONSTRICTING and SQUEEZING in nature ASSOCIATED COMPLAINT: palpitation, BREATHLESSNESS, sweating, nausea,and feeling of anxiety
  14. 14. o MODIFYING FACTORS: Aggravating factor Relieving factors  For the history of pain we use acronym 7. o SOCRATES.
  15. 15. PAST HISTORY MEDICALhypertensive diabetic  SURGICAL- no 
  16. 16. PERSONAL HISTORY SMOKER from last 15 years  No other HO of drug addiction 
  17. 17. FAMILY HISTORY Family history of • diabetes • hypertension • ischemic heart disease  Father died of MI 15 year back 
  18. 18. DRUG HISTORY Anti-hypertensive  Metformin for diabetes 
  19. 19. SUMMARAY OF HISTORY Ideas  Concerns  Expectations 

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