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Heart Education Awareness Resource and Training through E-learning

04: Acute Coronary Syndrome: Case 1 Hamish

The GP assesses Hamish

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  1. S(ite): Q. Where is your chest pain Hamish?
    A: In the centre of my chest.
  2. O(nset): Q. When did the chest pain start?
    A: It started this morning in the house and was there when I was walking to the surgery.
  3. C(haracter): Q. What does the chest pain feel like?
    A: It feels like a tightness across my chest.
  4. R(adiation): Q. Does the pain go anywhere else?
    A: It can go down my left arm but not every time.
  5. A(ssociated Factors): Q. Do you feel anything else besides the chest pain?
    A: I feel sick and sweaty at times.
  6. T(ime): Q. How long does the pain last, Hamish and does it ever come on at rest?
    A: It usually goes away when I stop walking, about 10-15 mins and yes it has done in the last couple of days.
  7. E(xacerbating): Q. Is there anything that makes the pain worse or better?
    A: If I take an indigestion tablet, it may ease the pain but not always.
  8. S(everity): Q. How bad is your pain Hamish, with 1 being little or no pain and 10 being the worst pain you’ve ever felt?
    A: It's about 7 this morning but can be less depending on what I am doing.

Dr Donald reviews the ECG that Iona performed and gives Hamish 300mgs of Aspirin to chew and 2 puffs of GTN spray sublingually. The pain resolves within 2 minutes. (Patients presenting with acute chest pain need to be assessed urgently and have a diagnostic Electrocardiogram (ECG) performed as quickly as possible to determine the correct treatment.)

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Rapid assessment and accurate diagnosis lead to prompt treatment and better outcomes

For further information on the clinical assessment of your patient for ACS see.

What happens next?

Module name: Acute Coronary Syndrome

Map name: 04: Acute Coronary Syndrome: Case 1 Hamish

Map ID: 1478

Node ID: 39853