Doctor: "Good morning, Mr. Doe. How are you feeling today?" Patient: "Not too great, Doc. I've been having this chest pain that’s really worrying me." Doctor: "Alright, let’s go over everything carefully. When did the pain start?" Patient: "It began about three days ago. It’s not constant, but it comes and goes." Doctor: "Can you describe the pain for me? What does it feel like?" Patient: "Yeah, it’s like a sharp, stabbing pain, right here in the middle of my chest." points to chest "It sort of spreads down my left arm too." Doctor: "I see. How intense is the pain on a scale of 1 to 10, with 10 being the worst pain imaginable?" Patient: "When it hits, I’d say it’s about a 7. It’s pretty bad, but not unbearable." Doctor: "How long does each episode last?" Patient: "Usually about 10 to 15 minutes, then it goes away." Doctor: "Does anything make it worse or bring it on?" Patient: "Yeah, when I’m doing anything physical, like walking up stairs or lifting something heavy, it gets worse. But if I rest for a bit, it goes away." Doctor: "That’s important to note. Have you noticed anything else when the pain comes on? Like shortness of breath, sweating, or dizziness?" Patient: "Yeah, I do feel short of breath sometimes, and once or twice I’ve gotten a little dizzy. But I haven’t noticed any sweating or nausea." Doctor: "Any recent injuries or trauma to your chest?" Patient: "No, nothing like that." Doctor: "Have you ever experienced this kind of pain before?" Patient: "No, this is the first time I’ve felt anything like this." Doctor: "Okay. Let’s talk about your medical history. Do you have any conditions we should know about?" Patient: "Yeah, I’ve got high blood pressure. I’ve been on Lisinopril for a few years." Doctor: "Any other conditions, like diabetes, high cholesterol, or heart disease?" Patient: "No, just the high blood pressure." Doctor: "Are you taking any other medications besides the Lisinopril?" Patient: "No, that’s the only one." Doctor: "Do you smoke or drink alcohol?" Patient: "Yeah, I smoke. I’ve been smoking for about 20 years now. I don’t really drink much, maybe a couple beers on the weekends." Doctor: "How many cigarettes do you smoke a day?" Patient: "Around a pack a day." Doctor: "Okay, we’ll definitely want to keep that in mind. Any family history of heart disease or other serious health issues?" Patient: "Yeah, my dad had a heart attack when he was 50. That’s why I’m kind of freaking out about this pain." Doctor: "I can understand that. It’s good you came in to get this checked. Have you traveled recently, or had any fevers, cough, or infections?" Patient: "No, I’ve just been at home. No fever or anything." Doctor: "Alright, thanks for sharing all of that. Let me take a closer look at you and run through a physical exam." Doctor: "I’m going to start by checking your vitals. Let’s check your blood pressure first... It’s 145 over 90, a bit on the high side. Have you had any issues with your blood pressure recently?" Patient: "Not that I know of. I usually check it at home, and it’s been okay." Doctor: "Okay, let’s check your pulse and oxygen levels. Your heart rate is 88 beats per minute, and your oxygen saturation is 97%. That’s good. Now I’ll take a listen to your heart." Doctor listens to the patient's heart with a stethoscope. Doctor: "Your heart sounds regular, no unusual sounds or murmurs. Let me listen to your lungs." Doctor listens to the patient’s lungs. Doctor: "Lungs are clear, no wheezing or crackles. Can you take a deep breath for me? Do you feel any pain when you breathe deeply?" Patient: "No, no pain with breathing." Doctor: "Good. Now, I’ll press on your chest a little. Let me know if this hurts." Doctor presses on the chest. Patient: "No, that doesn’t hurt." Doctor: "Great, no tenderness to palpation. I’m going to check your abdomen now." Doctor palpates the abdomen. Doctor: "Your abdomen feels normal, no signs of swelling or pain. I’ll check your legs now for any swelling or other issues." Doctor checks the legs and extremities. Doctor: "No swelling or signs of blood clots. How are your legs feeling otherwise?" Patient: "Yeah, my legs feel fine." Doctor: "Lastly, I’ll do a quick neurological exam. Can you squeeze my fingers for me? Great, your strength is normal. I’ll just check your reflexes quickly." Doctor checks reflexes. Doctor: "Everything looks good neurologically, no deficits there."