Comprehensive Case Study: 49-Year-Old Patient with Intermittent Squeezing Chest Pain (CLASS 6512) | iHuman Case Analysis Week #7
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I-Human Case Week #7
I Human Case Week 7 (6512): Comprehensive Case Study of a 49-Year-Old Patient with Intermittent Squeezing Chest Pain | Includes HPI, PE, Differential Diagnosis, and Management Plan | | I HUMAN CASE WEEK #7 49 YEAR OLD PATIENT : REASON FOR ENCOUNTER ; INTERMITTENT SQUEEZING CHEST PAIN (6512) | EXPER...
Comprehensive Case Study: FLORENCE BLACKMAN A 49-Year-
Old Patient with Intermittent Squeezing Chest Pain (CLASS 6512) |
iHuman Case Analysis Week #7
Patient Overview:
Patient Name: Florence Blackman
Age: 49 years old
Height: 5'6" (168 cm)
Weight: 158.0 lb (71.8 kg)
Reason for Encounter: Intermittent squeezing chest pain
Florence Blackman presents with:
Intermittent squeezing chest pain, a cardinal symptom that raises concern for possible
cardiovascular pathology such as ischemic heart disease.
Florence has:
A history of intermittent chest discomfort characterized by squeezing sensations, which may
suggest myocardial ischemia. Given her age, gender, and the nature of the pain, ischemic heart
disease (IHD) should be a high-priority differential diagnosis.
Florence is concerned because:
A doctor friend suggested that the chest pain could be significant, indicating that even
healthcare professionals are concerned about the underlying cause.
Initial clinical impression:
Chest pain of this nature could be due to several causes ranging from benign conditions like
musculoskeletal pain to more serious concerns like coronary artery disease (CAD). Immediate
action should be taken to assess for life-threatening conditions, including:
Acute coronary syndrome (ACS)
Myocardial infarction (MI)
Pulmonary embolism (PE)
,What brought you to the clinic today?
"It’s my heart… I was having really bad chest pain. It’s a bit better now, but it still hurts."
How severe is the pain on a scale of 1 to 10?
"Now it’s an 8. On the mountain, it felt like a 12 (weak smile)."
What were you doing when the chest pain started?
"I was going uphill on a cross-country ski course. I’ve done it many times before with no problem. Today, it
was a bit colder than usual, and the entire course felt more difficult."
Does the pain radiate to any other part of your body?
"Yes, it radiates to my left arm."
Do you have any other symptoms or concerns?
"I just started feeling short of breath, which is strange since I’m lying down."
Do you have any history of smoking?
"Yes."
Are you currently taking any prescription medications?
"Yes. I have a list in my wallet." (Medications include Metoprolol 25 mg, Hydrochlorothiazide 125 mg,
Atorvastatin 80 mg, Aspirin 81 mg, and Clopidogrel 75 mg.)
Have you ever had chest pain like this before?
"Yes, I’ve had chest pain before, but nothing like this. I almost feel like I might not make it this time. Am I
overreacting?"
Do you have any known allergies?
"Not that I know of."
10. Have you noticed any other symptoms like nausea, sweating, or anxiety?
"Yes, I feel nauseous and have been sweating. I also feel anxious. I’ve never felt chest pain like this."
History of Present Illness (HPI)
Florence describes the pain as:
Intermittent and squeezing, which are classic descriptors for cardiac-related pain. These
characteristics warrant further investigation into the possibility of angina pectoris.
Florence reports that the pain is:
Episodic, which may suggest stable angina, especially if triggered by exertion or emotional stress
and relieved by rest or nitroglycerin.
Florence has not mentioned:
Associated symptoms such as nausea, diaphoresis, or shortness of breath yet, but these should be
actively investigated as they could point to a more urgent cardiac condition like unstable angina or
myocardial infarction.
Florence needs further clarification on:
Risk factors for cardiovascular disease, such as her family history, smoking status, hypertension,
hyperlipidemia, and lifestyle factors like diet and exercise habits.
,
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