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chest pain is located in 'the middle' of his chest

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experiencing nausea

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Pulse is 94 and steady

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pain getting worse over time

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49M

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normal temp
family history

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Overweight/Cholestrol/BP

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- Worse on exertion
- Goes away when still
- Intermitent
- Mid chest

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nausea

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Chest pain started yesterday

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- musculoskeletal
- cardiac event
- pleural

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Temperature 37 degrees Celsius

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How would you describe the pain?
How severe is the pain?
Is it radiating?
Have you done a lot of exercise recently?
Where exactly is the pain?

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overexertion
bacterial/viral infection

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Worried he might be experiencing a heart attack

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Last ate/drank?

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Medications/ Existing health conditions/ Family history

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Medications/ Existing health conditions/ Family history

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Is there anything else that you're feeling?

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Is there anything else that you're feeling?

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Any nausea, sense of impending doom, sweating, light-headedness or shortness of breath?

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Any vomiting?

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Is it worse when moving arms or head/neck to certain positions?

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Is it worse when moving arms or head/neck to certain positions?

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- Not experienced pain like this before
- pain early yesterday morning, when puts arms overhead
- sharp pain
- sick in stomach
- pain has worsened, all the time now unless still
- Just joined gym, exercised for first time in a long time
- ‘lifting heavy weights’
- father had chronic lung condition
- High cholesterol - dyslipidaemia
- mild hypertension
- sedentary job

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- Lipitor
- Perindopril

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- especially on the sides of his sternum
- history of dyslipidaemia
- takes Lipitor and Perindopril

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- Dyslipidaemia
- Lipitor
- Perindopril

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- Father had a cardiac event and chronic lung condition

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- movement, raises hands above head
- breathing

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how lipitor works
how perindopril works

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mechanisms of muscular injury and pain

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atherosclerosis / cholesterol deposits

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MSK workup of upper arms - attempt to reproduce pain

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MSK workup of upper arms - attempt to reproduce pain

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Force, ROM, tenderness

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gentle pressing on sides of sternum to test for tenderness

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- ECG to rule out heart issues
- Triponin to rule out a cardiac event having occurred
- Potentially chest x-ray/CT bc of family history of lung condition

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- chest oscillation
- reproducibility of pain

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- visible markers

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- high BP
- tenderness with palpitation
- increased pain with all upper body movement
- tenderness to palpitation of sternum and costochondral region
- no swelling or redness

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Conjunctival Pallor - paleness of the conjunctiva (mucous membrane around eyes). If not red, an indicator of anaemia

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conjunctival pallor - conjunctiva should be quite red coloured. in people who are anaemic, conjunctiva will appear yellow-ish.
- apex beat - costochondral region
-

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Listening at the apex of the heart
https://www.youtube.com/watch?v=llE0nuysVa0

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to be determined

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https://miro.com/welcomeonboard/Zk40WHZCNjZRUGc2eWl1dFBZZnJDNHFHb1VNQktNaDhWaVFMaUNHR016MVhrUmJJaVBJbVROMzVXRFkyY2d4WHwzNDU4NzY0NTQ1MTUwODIwNDg2fDI=?share_link_id=300013353183

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https://miro.com/app/board/uXjVPqCzhLU=/?share_link_id=87956749802

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Is there a test which can determine affected muscles? if it is DOMs?