brian foster chest pain shadow health assessment Transcript
Brian foster chest pain shadow health assessment Transcript
Transcript
All Lines (209)Interview Questions (78)Statements (13)Exam Actions (118)
Hello. I am June and will be interviewing you today, and later conduct a physical exam
Greet
03/25/20 10:27 AM PDT
Good morning.
Please let me know your name (Clarified to Can you verify your identity please?.)
Question
03/25/20 10:28 AM PDT
Brian Robert Foster. (Clarified to to confirm what is my name.)
WE ARE THE SHADOW HEALTH EXPERTS,
CHAT US TO PLACE OUR ORDER AND SCORE 100%
Welcome Mr Foster. What brings you to the clinic today?
Question
03/25/20 10:29 AM PDT
I have been having some troubling chest pain in my chest now and then for the past month.
I am sorry that you have been having the chest pain. brian foster chest pain shadow health assessment Transcript
Empathize
03/25/20 10:30 AM PDT
Thanks. I appreciate that.
Please tell me what the pain you have been having is like (Clarified to Can you tell me what the pain is like?.)
Question
03/25/20 10:31 AM PDT
Well, it mostly feels tight and uncomfortable right in the middle of my chest. (Clarified to if I can tell you what the pain is like.)
when did the pain start?
Question
03/25/20 10:32 AM PDT
I first noticed it earlier this month. I thought it might just be heartburn and it passed after about a couple of minutes.
does the chest pain radiate?
Question
03/25/20 10:33 AM PDT
The pain doesn’t radiate anywhere. It’s mostly just right in the middle of my chest.
Do you feel pain in your arm?
Question
03/25/20 10:33 AM PDT
No, when I am having the chest pain, it’s mostly just in middle of my chest.
do you feel pain in your shoulder?
Question
03/25/20 10:36 AM PDT
No, the pain hasn’t been in my shoulder.
do you have back pain?
Question
03/25/20 10:36 AM PDT
I haven’t had back pain, no.
do you have neck pain.
Question
03/25/20 10:37 AM PDT
My neck’s been fine.
how long does the chest pain last ?
Question
03/25/20 10:37 AM PDT
When I feel it, it seems to get better over the course of a couple of minutes or so.
what is the frequency of the chest pain?
Question
03/25/20 10:37 AM PDT
Well, it has happened three times the past month. It usually goes away after about a couple of minutes.
Were episodes of your chest pains related? (Clarified to What were you doing the last time you had chest pain?.)
Question
03/25/20 10:39 AM PDT
Well, the pain seems to start when I’m doing something physical . . . the first time it happened while I was doing yard work, and the second time . . . I had to take the stairs at work because the elevator broke. Both times it got better if I took a break or sat down to rest. (Clarified to what I was doing when I had chest pain last.)
how do you feel when in pain? (No matching questions found.)
Question
03/25/20 10:41 AM PDT
am sorry about that? (No matching questions found.)
Question
03/25/20 10:42 AM PDT
How would you rate the chest pain?
Question
03/25/20 10:43 AM PDT
When I’m having it, it’s really tight and uncomfortable. Maybe like a 5 out of 10. Right now it’s like a zero.
is the pain crushing ?
Question
03/25/20 10:43 AM PDT
No, it’s more tight and uncomfortable.
Am sorry about that. (No matching questions found.)
Question
03/25/20 10:44 AM PDT
Am sorry about that.
Empathize
03/25/20 10:44 AM PDT
Thanks. I appreciate that.
is the pain gnawing?
Question
03/25/20 10:44 AM PDT
No, it’s not like that. [AUDIO COMING SOON]
is the pain burning ?
Question
03/25/20 10:45 AM PDT
Not really.
is the pain aggravated by activity?
Question
03/25/20 10:45 AM PDT
Well, I think it’s when I’m doing something physical most of the time. The first time it happened, my chest started hurting after I was doing some yard work. The second time happened when the elevator broke at work so I had to take the stairs. My office is on the 5th floor.
Thats understandable (No matching questions found.)
Question
03/25/20 10:46 AM PDT
Thats understandable
Empathize
03/25/20 10:46 AM PDT
Thanks. I appreciate that.
does eating make your pain get worse ? (Clarified to Do certain foods make the pain worse?.)
Question
03/25/20 10:47 AM PDT
I don’t think that has anything to do with it, but I guess I don’t know. (Clarified to if certain foods make the pain worse.)
does lying down help your pain?
Question
03/25/20 10:48 AM PDT
I’m not sure. I think lying still seems to help a little.
Have you taken medication for the pain?
Question
03/25/20 10:48 AM PDT
No, not yet.
Have you taken any anxiety medication?
Question
03/25/20 10:49 AM PDT
I’ve never taken anxiety meds. My life is pretty easy. [AUDIO COMING SOON]
Have you taken any medication?
Question
03/25/20 10:53 AM PDT
Yeah, let’s see, I take atorvastatin for cholesterol, metoprolol for blood pressure. . . Oh yeah, and I take fish oil too. I hear that’s good for your cholesterol. [AUDIO COMING SOON]
True, that good for your cholesterol, continue taking it.
Educate
03/25/20 10:54 AM PDT
Good to know. Thank you.
What dosage of metoprolol do you take?
Question
03/25/20 10:56 AM PDT
I think it’s 100 mg, once a day.
what about the dose of atorvastatin medication? (No matching questions found.)
Question
03/25/20 10:57 AM PDT
what is the dose of atorvastatin medication?
Question
03/25/20 10:58 AM PDT
I think it’s twenty milligrams a day.
How long have you been taking atorvastatin and metoprolol? (No matching questions found.)
Question
03/25/20 10:58 AM PDT
How long have you been taking atorvastatin?
Question
03/25/20 10:59 AM PDT
I think about a year. [AUDIO COMING SOON]
How long have you taken metoprolol?
Question
03/25/20 10:59 AM PDT
I think it’s been about one year.
Are you allergic?
Question
03/25/20 11:01 AM PDT
No, well . . . I’ve had a bad reaction to codeine before, but that is all I know of.
Have you been diagnosed with hypertension?
Question
03/25/20 11:02 AM PDT
Yes, I supposedly have moderately high blood pressure.
Am sorry to hear this?
Empathize
03/25/20 11:02 AM PDT
Thanks. I appreciate that.
have you been told your cholesterol is high?
Question
03/25/20 11:03 AM PDT
I’ve been told it’s moderately high. I’ve never noticed any actual symptoms from that though.
Have you been tested for diabetes?
Question
03/25/20 11:04 AM PDT
My mom and my sister both have diabetes, but I don’t have it.
Did you have any treatment for chest pain?
Question
03/25/20 11:06 AM PDT
I don’t have any shortness of breath, just the chest pain.
Have you been monitoring your blood pressure?
Question
03/25/20 11:07 AM PDT
Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it.
do you remember your last blood pressure readings?
Question
03/25/20 11:08 AM PDT
I don’t remember. I don’t think it was too bad, though.
have you done an EKG test recently?
Question
03/25/20 11:08 AM PDT
I had one about three months ago. They usually put one on me at my annual physical.
well, an EKG test is all about blood pressure monitoring.
Educate
03/25/20 11:09 AM PDT
Good to know. Thank you.
what was the result of the EKG?
Question
03/25/20 11:09 AM PDT
I don’t remember the actual results, but as far as I know, it was normal.
Do you have a primary care provider?
Question
03/25/20 11:10 AM PDT
Dr. Melinda Smith.
Great.
Educate
03/25/20 11:10 AM PDT
Good to know. Thank you.
When did you last visit your care provider?
Question
03/25/20 11:10 AM PDT
I had a physical about 3 months ago.
Do you have stress?
Question
03/25/20 11:11 AM PDT
Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest.
Am sorry about this.
Empathize
03/25/20 11:11 AM PDT
Thanks. I appreciate that.
Do you exercise?
Question
03/25/20 11:12 AM PDT
Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.
Am sorry that the chest pain makes you not exercise.
Empathize
03/25/20 11:13 AM PDT
Thanks. I appreciate that.
what is your typical breakfast?
Question
03/25/20 11:13 AM PDT
I usually have something. Most days I drink an instant breakfast, or I’ll have a granola bar. Sometimes Maria will make a big breakfast on weekends with eggs, pancakes, bacon, hash browns, that kind of stuff.
what is your typical lunch?
Question
03/25/20 11:14 AM PDT
There’s a sub shop near the office, so I usually get a turkey or Italian sub from there. Sometimes a salad if I’m feeling healthy . . . or guilty.
what is your typical dinner?
Question
03/25/20 11:14 AM PDT
My wife and I like to grill. We usually have some grilled meats and veggies for dinner.
do you take salt? (No matching questions found.)
Question
03/25/20 11:15 AM PDT
Do you drink water regularly?
Question
03/25/20 11:15 AM PDT
I usually drink water all day at work. At least four glasses, probably more. [AUDIO COMING SOON]
Its good to take water, continue.
Educate
03/25/20 11:16 AM PDT
Good to know. Thank you.
Do you smoke cigarettes?
Question
03/25/20 11:17 AM PDT
Nope, I had a lot of friends who did but I never started.
Do you take alcohol?
Question
03/25/20 11:17 AM PDT
I rarely drink during the week. If I drink at all it’s a couple beers on the weekend while I’m grilling or watching football. Maybe a little bourbon occasionally.
thats moderate drinking.
Educate
03/25/20 11:18 AM PDT
Good to know. Thank you.
Do you have fever?
Question
03/25/20 11:18 AM PDT
I haven’t had a fever, no.
do you have chills?
Question
03/25/20 11:18 AM PDT
I haven’t had chills, no.
Do you have fatigue?
Question
03/25/20 11:18 AM PDT
I’m not more tired than normal.
do you have night sweats ?
Question
03/25/20 11:19 AM PDT
Nope, no night sweats.
Do you feel dizzy?
Question
03/25/20 11:19 AM PDT
No, I haven’t felt dizzy.
Do you have palpitations?
Question
03/25/20 11:19 AM PDT
I don’t think so. I haven’t noticed any.
Have you had angina?
Question
03/25/20 11:20 AM PDT
I’ve never been diagnosed with angina. [AUDIO COMING SOON]
have you ever had edema?
Question
03/25/20 11:20 AM PDT
I haven’t noticed any swelling.
have you had blood clots?
Question
03/25/20 11:20 AM PDT
Not that I know of.
Any history of of rheumatic fever?
Question
03/25/20 11:21 AM PDT
No, I never had that.
do you have history of heart murmur?
Question
03/25/20 11:21 AM PDT
No, none that I know of.
do you have a cough?
Question
03/25/20 11:22 AM PDT
I don’t have a cough.
do you have difficulty breathing?
Question
03/25/20 11:22 AM PDT
My breathing’s fine.
Do you have orthopnea?
Question
03/25/20 11:22 AM PDT
Orthopnea? That sounds like the name of a weird bird. [AUDIO COMING SOON]
Well, Thats shortness of breath?
Educate
03/25/20 11:23 AM PDT
Good to know. Thank you.
Do you have shortness of breath?
Question
03/25/20 11:23 AM PDT
My breathing’s fine.
Do you have sore throat?
Question
03/25/20 11:24 AM PDT
I haven’t had a sore throat in a long time.
Do you have change in sense of taste?
Question
03/25/20 11:24 AM PDT
I can still taste things fine.
Do you have dysphagia?
Question
03/25/20 11:25 AM PDT
I haven’t had any trouble swallowing.
Do you have nausea?
Question
03/25/20 11:25 AM PDT
No, I haven’t felt nauseous. I just had pain in my chest.
do you have diarrhea ?
Question
03/25/20 11:28 AM PDT
I have, but it is very rare for me.
Do you have constipation?
Question
03/25/20 11:29 AM PDT
I haven’t had problems with that. I wish it were only that.
do you have heartburn or GERD?
Question
03/25/20 11:29 AM PDT
No, I’ve never had problems with heartburn. I sure hope that’s all this is, but it’s pretty intense if it’s heartburn.
Do you have a family history of heart attack? brian foster chest pain shadow health assessment Transcript
Question
03/25/20 11:30 AM PDT
Well, my mom’s dad died of a heart attack. He was pretty young too.
Do you have a family history of stroke?
Question
03/25/20 11:30 AM PDT
No, none that I know of.
Do you have a family history of pulmonary embolism?
Question
03/25/20 11:32 AM PDT
No, nobody had that.
Thank you Mr Foster for answering for answering my questions, I will now do the Physical examination. (No matching questions found.)
Question
03/25/20 11:34 AM PDT
Thank you Mr Foster for answering for answering my questions, I will now do the Physical examination. brian foster chest pain shadow health assessment Transcript
Educate
03/25/20 11:34 AM PDT
Good to know. Thank you.
Measured vitals
Exam Action
03/25/20 12:37 PM PDT
Tested blood pressure in left arm with cuff
Exam Action
03/25/20 12:41 PM PDT
Tested blood pressure in right arm with cuff
Exam Action
03/25/20 12:42 PM PDT
Measured vitals
Exam Action
03/25/20 12:43 PM PDT
Inspected face
Exam Action
03/25/20 12:44 PM PDT
Inspected for jugular venous distension: No jugular venous distention; JVP 3 cm above sternal angle
Exam Action
03/25/20 12:47 PM PDT
Inspected anterior chest wall
Exam Action
03/25/20 12:48 PM PDT
Inspected left side of abdomen
Exam Action
03/25/20 12:48 PM PDT
Inspected right hand: no visible abnormal findings
Exam Action
03/25/20 12:50 PM PDT
Inspected left hand: no visible abnormal findings
Exam Action
03/25/20 12:50 PM PDT
Inspected fingernails of left hand
Exam Action
03/25/20 12:50 PM PDT
Inspected right hand: no visible abnormal findings
Exam Action
03/25/20 12:50 PM PDT
Inspected left hand: no visible abnormal findings
Exam Action
03/25/20 12:50 PM PDT
Inspected fingernails of right hand
Exam Action
03/25/20 12:50 PM PDT
Inspected left leg
Exam Action
03/25/20 12:51 PM PDT
Inspected right leg
Exam Action
03/25/20 12:51 PM PDT
Inspected toenails on left foot
Exam Action
03/25/20 12:51 PM PDT
Inspected toenails on right foot
Exam Action
03/25/20 12:51 PM PDT
Inspected left leg
Exam Action
03/25/20 12:51 PM PDT
Inspected right leg
Exam Action
03/25/20 12:51 PM PDT
Inspected right leg for edema: No edema
Exam Action
03/25/20 12:53 PM PDT
Inspected left leg for edema: No edema
Exam Action
03/25/20 12:53 PM PDT
Checked capillary refill in fingernails brian foster chest pain shadow health assessment Transcript
Exam Action
03/25/20 12:53 PM PDT
Checked capillary refill in fingernails
Exam Action
03/25/20 12:53 PM PDT
Checked capillary refill in fingernails
Exam Action
03/25/20 12:53 PM PDT
Checked capillary refill in fingernails
Exam Action
03/25/20 12:53 PM PDT
Checked capillary refill in fingernails
Exam Action
03/25/20 12:54 PM PDT
Checked capillary refill in fingernails
Exam Action
03/25/20 12:54 PM PDT
Auscultated right carotid pulse: Bruit present
Exam Action
03/25/20 12:56 PM PDT
Auscultated left carotid pulse
Exam Action
03/25/20 12:56 PM PDT
Auscultated right carotid pulse: Bruit present
Exam Action
03/25/20 12:58 PM PDT
Auscultated right carotid pulse: Bruit present
Exam Action
03/25/20 12:58 PM PDT
Auscultated left carotid pulse
Exam Action
03/25/20 12:59 PM PDT
Auscultated aortic area with the bell
Exam Action
03/25/20 12:59 PM PDT
Auscultated aortic area with the diaphragm
Exam Action
03/25/20 12:59 PM PDT
Auscultated aortic area with the bell
Exam Action
03/25/20 12:59 PM PDT
Auscultated pulmonic area with the bell
Exam Action
03/25/20 12:59 PM PDT
Auscultated pulmonic area with the diaphragm
Exam Action
03/25/20 12:59 PM PDT
Auscultated Erb’s point with the diaphragm brian foster chest pain shadow health assessment Transcript
Exam Action
03/25/20 12:59 PM PDT
Auscultated Erb’s point with the bell
Exam Action
03/25/20 1:00 PM PDT
Auscultated Erb’s point with the diaphragm
Exam Action
03/25/20 1:00 PM PDT
Auscultated tricuspid area with the diaphragm
Exam Action
03/25/20 1:00 PM PDT
Auscultated tricuspid area with the bell
Exam Action
03/25/20 1:00 PM PDT
Auscultated tricuspid area with the diaphragm
Exam Action
03/25/20 1:00 PM PDT
Auscultated mitral area with the diaphragm
Exam Action
03/25/20 1:00 PM PDT
Auscultated mitral area with the bell
Exam Action
03/25/20 1:00 PM PDT
Auscultated mitral area with the diaphragm
Exam Action
03/25/20 1:00 PM PDT
Auscultated breath sounds in anterior right lower lobe
Exam Action
03/25/20 1:00 PM PDT
Auscultated breath sounds in anterior right middle lobe
Exam Action
03/25/20 1:00 PM PDT
Auscultated breath sounds in anterior right upper lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in anterior left upper lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in anterior left mid-chest (upper lobe)
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in anterior left lower lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior left lower lobe on side
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior left lower lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior left mid-back (lower lobe) brian foster chest pain shadow health assessment Transcript
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior left upper lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior right upper lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior right mid-back (lower lobe)
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior right lower lobe
Exam Action
03/25/20 1:01 PM PDT
Auscultated breath sounds in posterior right lower lobe on side
Exam Action
03/25/20 1:01 PM PDT
Auscultated aorta in abdomen
Exam Action
03/25/20 1:03 PM PDT
Auscultated right femoral pulse
Exam Action
03/25/20 1:05 PM PDT
Auscultated right iliac pulse
Exam Action
03/25/20 1:05 PM PDT
Auscultated right renal pulse
Exam Action
03/25/20 1:05 PM PDT
Auscultated left renal pulse
Exam Action
03/25/20 1:05 PM PDT
Auscultated left iliac pulse
Exam Action
03/25/20 1:05 PM PDT
Auscultated left femoral pulse
Exam Action
03/25/20 1:06 PM PDT
Auscultated right upper quadrant
Exam Action
03/25/20 1:07 PM PDT
Auscultated right lower quadrant
Exam Action
03/25/20 1:07 PM PDT
Auscultated left upper quadrant
Exam Action
03/25/20 1:07 PM PDT
Auscultated left lower quadrant
Exam Action
03/25/20 1:07 PM PDT
Auscultated right lower quadrant
Exam Action
03/25/20 1:12 PM PDT
Auscultated right upper quadrant
Exam Action
03/25/20 1:13 PM PDT
Auscultated right lower quadrant
Exam Action
03/25/20 1:14 PM PDT
Auscultated right upper quadrant
Exam Action
03/25/20 1:14 PM PDT
Auscultated left upper quadrant
Exam Action
03/25/20 1:14 PM PDT
Auscultated left lower quadrant
Exam Action
03/25/20 1:14 PM PDT
Auscultated over liver
Exam Action
03/25/20 1:19 PM PDT
Auscultated over spleen brian foster chest pain shadow health assessment Transcript
Exam Action
03/25/20 1:19 PM PDT
Palpated right carotid pulse: Thrill, 3+
Exam Action
03/25/20 1:21 PM PDT
Palpated left carotid pulse: No thrill, 2+
Exam Action
03/25/20 1:21 PM PDT
Palpated PMI: Displaced laterally; brisk and tapping; less than 3 cm
Exam Action
03/25/20 1:22 PM PDT
Palpated right brachial pulse: No thrill, 2+
Exam Action
03/25/20 1:23 PM PDT
Palpated left brachial pulse: No thrill, 2+
Exam Action
03/25/20 1:23 PM PDT
Palpated right radial pulse: No thrill, 2+
Exam Action
03/25/20 1:25 PM PDT
Palpated left radial pulse: No thrill, 2+
Exam Action
03/25/20 1:26 PM PDT
Palpated right femoral pulse: No thrill, 2+
Exam Action
03/25/20 1:26 PM PDT
Palpated left femoral pulse: No thrill, 2+
Exam Action
03/25/20 1:27 PM PDT
Palpated right popliteal pulse: No thrill, 1+
Exam Action
03/25/20 1:27 PM PDT
Palpated left popliteal pulse: No thrill, 1+
Exam Action
03/25/20 1:27 PM PDT
Palpated right tibial pulse: No thrill, 1+ brian foster chest pain shadow health assessment Transcript
Exam Action
03/25/20 1:28 PM PDT
Palpated left tibial pulse: No thrill, 1+
Exam Action
03/25/20 1:28 PM PDT
Palpated right dorsalis pedis pulse: No thrill, 1+
Exam Action
03/25/20 1:30 PM PDT
Palpated left dorsalis pedis pulse: No thrill, 1+
Exam Action
03/25/20 1:30 PM PDT
Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
03/25/20 1:31 PM PDT
Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
03/25/20 1:31 PM PDT
Palpated left lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
03/25/20 1:31 PM PDT
Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
03/25/20 1:31 PM PDT
Palpated right upper quadrant with deep pressure: No masses
Exam Action
03/25/20 1:32 PM PDT
Palpated right lower quadrant: with deep pressure: No masses
Exam Action
03/25/20 1:32 PM PDT
Palpated left lower quadrant with deep pressure: No masses
Exam Action
03/25/20 1:32 PM PDT
Palpated left upper quadrant with deep pressure: No masses
Exam Action
03/25/20 1:32 PM PDT
Palpated liver: Palpable 1 cm below right costal margin
Exam Action
03/25/20 1:33 PM PDT
Palpated for spleen: Not palpable
Exam Action
03/25/20 1:34 PM PDT
Palpated for right kidney: Not palpable
Exam Action
03/25/20 1:34 PM PDT
Palpated for left kidney: Not palpable
Exam Action
03/25/20 1:34 PM PDT
Tested skin turgor
Exam Action
03/25/20 1:34 PM PDT
Percussed right upper quadrant
Exam Action
03/25/20 1:36 PM PDT
Percussed right lower quadrant
Exam Action
03/25/20 1:36 PM PDT
Percussed left upper quadrant
Exam Action
03/25/20 1:36 PM PDT
Percussed left lower quadrant
Exam Action
03/25/20 1:36 PM PDT
Percussed spleen
Exam Action
03/25/20 1:37 PM PDT
Percussed for liver span: 7 cm in the mid-clavicular line
Exam Action
03/25/20 1:38 PM PDT
Performed EKG
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03/25/20 1:38 PM PDT
Inspected left side of abdomen
Exam Action
03/25/20 1:43 PM PDT
Inspected front of abdomen
Exam Action
03/25/20 1:46 PM PDT
Inspected left side of abdomen
brian foster chest pain shadow health assessment Transcript
Exam Action
03/25/20 1:46 PM PDT
