Doctor - patient conversation

Patient arrives for a visit, very alarmed and upset.

Doctor: Tell me, what seems to be the problem?
Patient: I have chest pain.
Doctor: How did the pain begin, what were you doing?
Patient: I was resting.
(This question is asked because almost half of the ischemic conditions occur after great physical activity, or emotional stress, or after consumption of alcoholic beverages. Chest pains can also occur frequently over the course of some time, which are signaling symptoms which the patient should relay to a physician as soon as possible.)
Doctor: Have you previously ever had the same sort of pain?
Patient: No, I have not.
(70% of cases ischemia occurs in patients who have never experienced any coronary symptoms.)
Doctor: Describe the pain.
Patient: My chest feels constricted, I feel as though I am drowning.
Doctor: How long has the pain been bothering you?
Patient: Approximately 30 minutes. Sometimes it’s a stabbing pain, other times it subsides, and begins anew. At times, I can barely stand it.
Doctor: Tell me, exactly where it hurts?
Patient: It’s on my sternum, then it expands on both sides of my chest, mostly on the left side.
(This question is asked because often the pain begins in the solar plexus, and stimulates gastric problems. (frequent burping, flatulence))
Doctor: Have you used any medication?
Patient: Nitroglycerine, but it did not have any effect.
Doctor: Do you have any other problems?
Patient: I sweat a lot. I have a hard time catching my breath sometimes (Patient appears pale), feels like I am choking.

Doctor enquires about breathing because patients often exhibit respiratory issues to the point of passing out.

During an infarction, a fever could also arise, sub febrile, which could also reach 38-39 degrees. This is due to the absorption of protein matter at the necrotic zone.

Doctor immediately recommends an EcG.

The EcG clearly exhibits the signs of infarct, which are :

    1. Necrosis
    2. Lesions
    3. Ischemia

Through the EcG, one determine the positioning of the ischemia, the degree of heart muscle involved in the ischemia.

Medically Reviewed by a doctor on 24 Jan 2018
Medical Author: Dr. med. Diana Hysi