"Hello, I’m [Your Name], one of the doctors/nurses. I understand you've come in today because you've been experiencing some chest pain. Is that right?"
"Before we go any further, what are your thoughts about what might be causing this chest pain, or what it might mean?"
"And is there anything in particular that you're worried about, or anything you were hoping we could achieve during our conversation today?"
"Could you please tell me exactly where the pain is? Can you point to it with one finger?"
"When did this pain first start, and did it come on suddenly or gradually? What were you doing when it started?"
"How would you describe the pain? Is it a tight, crushing, or heavy sensation? Or is it sharp, burning, or tearing? Does it get worse when you take a deep breath in?"
"Does the pain spread anywhere else? For example, does it go to your jaw, neck, arm (left or right), or back?"
"Have you noticed any other symptoms happening at the same time? Like shortness of breath, feeling your heart race or skip beats (palpitations), sweating, nausea, vomiting, or feeling dizzy?"
"How has the pain changed over time? Is it constant, or does it come and go in episodes? If it comes and goes, how long does each episode typically last?"
"What makes the pain better or worse? For example, does rest help, or does it get worse with activity? Does changing your position affect it? Have you tried any medications, like GTN spray or antacids, and did they help?"
"On a scale of 1 to 10, with 10 being the worst pain imaginable, how would you rate your pain right now? And how has it been affecting your daily activities or ability to function?"
"I also need to ask about some important 'red flag' symptoms. Did the pain start very suddenly and feel like a tearing sensation, perhaps radiating to your back? Was it associated with fainting? Or persistent vomiting?"
"Do you have any existing medical conditions, such as high blood pressure, high cholesterol, diabetes, previous heart attacks, angina, or strokes? What about lung conditions like asthma or COPD, or stomach issues like GORD (acid reflux)?"
"Have you ever had any operations or procedures, especially any heart surgeries like a bypass or stents?"
"Are you currently taking any medications, including anything prescribed by a doctor, or any over-the-counter medicines, supplements, or herbal remedies? This includes any medications for your heart, blood pressure, or cholesterol, or any new medications you've started recently."
"Do you have any allergies to medications or anything else? If so, what kind of reaction did you have?"
"Does anyone in your close family – like your parents, siblings, or children – have a history of heart disease, heart attacks, strokes, or sudden cardiac death? If so, how old were they when they were diagnosed?"
"Could you tell me a little about your living situation and who you live with? Do you have a good support network around you? Are you able to manage all your daily activities? What kind of work do you do, and have your symptoms affected your ability to work?"
"Do you smoke, and if so, how much and for how long? Have you ever tried to quit?"
"How much alcohol do you drink in a week?"
"Do you use any recreational drugs?"
"What's your typical diet like, and how often do you exercise?"
"Regarding driving, it's very important that you do not drive until you have been fully investigated for your chest pain and we understand the cause."
"Thank you very much for sharing all of that information with me. Just to summarise, you've been experiencing [recap key symptoms], which started [onset] and are often [character/timing]. You've also mentioned [recap relevant PMH/DH/FH/SH]."
"Does that sound like an accurate summary? Is there anything else you feel is important that we haven't covered?"
"Based on what you've told me, the next steps would be for me to perform a physical examination of your heart and lungs, and then we would likely arrange for some investigations, such as an ECG (heart tracing), blood tests, or potentially imaging, to understand what's causing your symptoms. Depending on the findings, we might need to admit you to the hospital for further assessment if we suspect a serious cardiac event."
"Do you have any questions for me at this stage?"
"Thank you for your time."