Rohit's Chest Pain

Name	Rohit Clark
DOB	09/11/1953 (61 years)
Occupation	Financial director
History	I am a talkative person who needs to be interrupted. I had a really sudden, really painful pain in the centre of my chest. It was so bad that I lost consciousness which was embarrassing as I was in a meeting at the time. It was a tearing pain that moved to my back. The pain was 10/10 in severity if not 11/10. Nothing made it worse or better. If pressed, I remember feeling a little dizzy before I collapsed and this feeling that I was going to die. When I regained consciousness I was not confused. I cannot think of anything that triggered this pain.
Past Medical History	I have never suffered from chest pain or any other diseases. I am not aware of having high blood pressure but the rest of my family does have it.
Drug History	Nil
Family History	My father, mother and brother all have very high blood pressure. I have been meaning to get it checked.
Social History	I do smoke around 10 per day but I don't drink. The smoking is just to cope with stress. I do not take recreational drugs. I live with my wife who I would really like to call and have so far been unable to do so.

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 nausea and sweating	0	1	2
Asks for shortness of breath	0	1
Asks for palpitations	0	1
Asks for loss of consciousness and dizziness	0	1	2
Asks for loss of sensation, balance, vision and weakness	0	1	2
Asks for seizure and confusion following waking up	0	1
Asks for fever, cough	0	1
Asks for heartburn/abdominal pain	0	1
Enquires about exacerbating factors including physical activity	0	1
Enquires about alleviating factors including rest	0	1
Asks about duration and changes to pain over time	0	1
Checks severity of pain	0	1
Asks about previous chest pain	0	1
Asks about recent illness and past medical history	0	1	2
Asks specifically for previous heart disease, stroke, diabetes, high cholesterol, hypertension and asthma	0	1
Asks about any family history of disease	0	1
Asks specifically if any family members have had cardiac disease below <55 years, cardiac disease, pulmonary embolism or sudden death	0	1
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
Asks about diet and lifestyle	0	1
Elicits patients occupation	0	1
Explores and responds to ideas	0	1
Explores and responds to concerns	0	1	2
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 (aortic dissection, myocardial infarction, aortic valve disease)	0	1