Baljit's Chest Pain

Name	Baljit Kaur
DOB	10/04/1989 (25 years)
Occupation	Postman
History	I am very anxious as 3 days ago I began experiencing a sharp pain in my chest that lasts a few seconds each time. I am convinced that I am having a heart attack like my father had. It is right over my heart. It moves to the neck. The pain is worse when I cough or lie down. It is better when I lean forward. I have no other symptoms. It is around 6/10 in severity. Yesterday I took some paracetamol which helped. If asked, admits to having the flu last week with symptoms of fatigue, fever, cough and runny nose.
Past Medical History	Nil
Drug History	Occasional paracetamol
Family History	Father died of heart attack 2 weeks ago
Social History	I do not smoke and I drink occasionally. I have been quite stressed since my father passed away because I am worried I will also have a heart attack. I used to exercise a lot but I have recently let myself go. I used to walk a lot on the job but now I have to use a van. I don't take any recreational drugs.

Introduces yourself	0	1
Confirms name & age of patient	0	1
Explains reason for consultation & builds rapport	0	1
Gains consent	0	1
Asks open question	0	1
Establishes site	0	1
Asks about onset	0	1
Elicits character of pain	0	1
Asks if pain radiates	0	1
Asks for associated symptoms of fever, cough and nausea	0	1	2
Asks for associated symptoms of shortness of breath, palpitations,loss of consciousness	0	1	2
Excludes heartburn and abdominal pain	0	1
Enquires about exacerbating factors including physical activity, lying down, coughing and chest tenderness	0	1	2
Enquires about alleviating factors including rest, leaning forward, painkillers	0	1
Asks patient to rate severity of pain	0	1
Asks about previous chest pain	0	1
Asks about recent illnesses	0	1
Asks specifically for recent illness, surgery and calf pain or leg swelling	0	1	2
Asks about any family history of disease	0	1
Asks specifically if any family members have had any pulmonary embolisms or clots	0	1	2
Establishes any drugs patient is on	0	1
Asks if patient has any allergies	0	1
Asks if patient smokes, drinks or takes recreational drugs	0	1	2
Asks about diet and lifestyle	0	1
Asks about any recent travel	0	1
Elicits patients occupation	0	1
Explores and responds to ideas	0	1
Explores and responds to concerns	0	1
Explores and responds to expectations	0	1
Shows empathy	0	1
Avoids jargon	0	1
Summarises back to patient	0	1
Thanks patient	0	1
Patient global score	0	1	2
Gives reasonable differential diagnosis (pericarditis, anxiety, musculoskeletal etc)	0	1