Chest Pain

Question 1

Name

Answer 1

Jo Coleman

Question 2

Age

Answer 2

49

Question 3

DOB

Answer 3

4/12/73

Question 4

Job (2)

Answer 4

• Administrator in the council
• Working from home.

Question 5

Opening Statement (2)

Answer 5

• “I’ve think I’ve got indigestion and I’m sorry to waste your time but it’s not getting better”
• Put a fist over your central chest area and press in slightly as you say this.

Question 6

Symptoms (2)

Answer 6

• On and off
• Tight, central chest discomfort

Question 7

Symptoms if pushed (3)

Answer 7

• Also feel a bit nauseous and lightheaded
• The pain does goes up into your jaw sometimes, but nowhere else
• Might have been getting more breathless recently

Question 8

Since when? (3)

Answer 8

• Past six weeks
• None now
• None in the last three days

Question 9

Pain level (3)

Answer 9

• not bad
• 3 or 4 out of 10
• Stops me in my tracks

Question 10

When does it go away?

Answer 10

If I stop to rest the feelings go away after a minute or so

Question 11

When does the pain come on? (4)

Answer 11

• During exertion
• Never when at rest
• Isn’t getting more frequent
• Isn’t coming on more easily

Question 12

What do I think is causing the pain? (2)

Answer 12

• Indigestion (it’s that kind of area)
• Recent stress

Question 13

Am I taking anything for the pain?

Answer 13

Keep a pack of Rennie’s with me, but not sure if they help because it just goes away when I stop doing stuff

Question 14

First time it happened (7)

Answer 14

• Moving house 6 weeks ago
• Carrying boxes up stairs
• Felt unwell, breathless, and like I was gonna be sick
• Sat on stairs and partner said I looked pale
• She was gonna call and ambulance, but it was gone after I sat down for a bit
• Remembered I’d just eaten a pasty so thought it must have been that
• Didn’t want to call an ambulance because the NHS is so stretched at the moment

Question 15

Second time it happened (2)

Answer 15

• Couple of weeks later
• Decorating

Question 16

Subsequent attacks (3)

Answer 16

• Digging in the garden
• Walking the dogs up a steep hill
• Taking a Rennie and returning to the activity a bit more slowly seems to help

Question 17

Other medical issues (2)

Answer 17

• Bit of knee arthritis
• Slightly overweight

Question 18

Operation?

Answer 18

Never

Question 19

Medication

Answer 19

• Paracetamol for knee
• Rennie for heart pains

Question 20

Homelife? (2)

Answer 20

• Partner
• Two dogs

Question 21

Diet (2)

Answer 21

• Quite rich food
• Don’t really like fruit or veg

Question 22

Hobbies (3)

Answer 22

• watching TV
• drawing
• quite sedentary until recently

Question 23

Exercise?

Answer 23

Walk dogs around the corner – they’re pretty lazy

Question 24

Recent change in lifestyle (2)

Answer 24

• moved to bigger house
• big garden and much busier with decorating / gardening etc

Question 25

Alcohol? (2)

Answer 25

• Not really
• Like fizzy drinks though

Question 26

Smoke?

Answer 26

10 a day

Question 27

Father (3)

Answer 27

• Didn’t know him
• Heard he liked to drink
• Died of a heart attack in 50s?

Question 28

Mum (3)

Answer 28

• Died two years ago
• Lung cancer
• Found out when she had chest pain and difficulty breathing

Question 29

Siblings / children?

Answer 29

None

Question 30

How are things at home?

Answer 30

My partner is very caring and supportive but thank you for asking.

Question 31

My ideas (4)

Answer 31

• Not quite sure what’s going on
• Think it’s indigestion
• Maybe stress might be causing it? Not sure how.
• Back of mind is mum’s lung cancer (definitely gonna give up smoking now)

Question 32

Second session questions (4)

Answer 32

• What is angina?
• Why does it cause pain?
• Is it serious?
• When and how should I use a GTN spray?

Question 33

Notes to actor of first two scenarios (4)

Answer 33

• Please play these first two parts as friendly.
• You are mildly dismissive of your symptoms and keen not to waste the doctor’s time as it’s probably nothing.
• At the back of your mind is your mum though (see scenario) so you do want to check it out.
• You will be told by the tutor or the student that they think this pain is coming from your heart. You will be a little surprised, but you are a very practical person and you are not at all upset or rattled by this.

Question 34

Challenge Scenario general directions (5)

Answer 34

• mixed feelings - sure there is nothing wrong & anxious
• you wish you’d never rung the doctor
• don’t want to waste anyone’s time.
• Argue with the student that you are sure it isn’t your heart.
• Your anxiety about what will happen next has tipped you into denial and a student who is gently reassuring but lets you know that this could be serious will win you round.

Question 35

Challenge Scenario Opening Sentence

Answer 35

“Look, the GP has just told me that they think it’s my heart and I should go up to the hospital for tests—they are sorting an appointment out for me, but y’know I think I’m just wasting everyone’s time and I don’t want to go, so I’ll just leave now if that’s okay?”

Question 36

Aim of challenge scenario?

Answer 36

You, the tutor and the group should come up with some ideas of how to intervene. They should try and persuade you to stay until the GP gets back. You may also have some ideas on what might help. If time a student can then try these out.