Chest Pain Flashcards
Name
Jo Coleman
Age
49
DOB
4/12/73
Job (2)
- Administrator in the council
- Working from home.
Opening Statement (2)
- “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.
Symptoms (2)
- On and off
- Tight, central chest discomfort
Symptoms if pushed (3)
- 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
Since when? (3)
- Past six weeks
- None now
- None in the last three days
Pain level (3)
- not bad
- 3 or 4 out of 10
- Stops me in my tracks
When does it go away?
If I stop to rest the feelings go away after a minute or so
When does the pain come on? (4)
- During exertion
- Never when at rest
- Isn’t getting more frequent
- Isn’t coming on more easily
What do I think is causing the pain? (2)
- Indigestion (it’s that kind of area)
- Recent stress
Am I taking anything for the pain?
Keep a pack of Rennie’s with me, but not sure if they help because it just goes away when I stop doing stuff
First time it happened (7)
- 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
Second time it happened (2)
- Couple of weeks later
- Decorating
Subsequent attacks (3)
- 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
Other medical issues (2)
- Bit of knee arthritis
- Slightly overweight
Operation?
Never
Medication
- Paracetamol for knee
- Rennie for heart pains
Homelife? (2)
- Partner
- Two dogs
Diet (2)
- Quite rich food
- Don’t really like fruit or veg
Hobbies (3)
- watching TV
- drawing
- quite sedentary until recently
Exercise?
Walk dogs around the corner – they’re pretty lazy
Recent change in lifestyle (2)
- moved to bigger house
- big garden and much busier with decorating / gardening etc
Alcohol? (2)
- Not really
- Like fizzy drinks though
Smoke?
10 a day
Father (3)
- Didn’t know him
- Heard he liked to drink
- Died of a heart attack in 50s?
Mum (3)
- Died two years ago
- Lung cancer
- Found out when she had chest pain and difficulty breathing
Siblings / children?
None
How are things at home?
My partner is very caring and supportive but thank you for asking.
My ideas (4)
- 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)
Second session questions (4)
- What is angina?
- Why does it cause pain?
- Is it serious?
- When and how should I use a GTN spray?
Notes to actor of first two scenarios (4)
- 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.
Challenge Scenario general directions (5)
- 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.
Challenge Scenario Opening Sentence
“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?”
Aim of challenge scenario?
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.
