Focused Exam: Chest Pain, Brian Foster Shadow health transcript

	Hello	Greet 04/15/23 1:09 PM EDT
	Good morning.
	What brings you in today?	Question 04/15/23 1:09 PM EDT Struggling to meet your deadline? Get your assignment on Focused Exam: Chest Pain, Brian Foster Shadow health transcript done by certified MDs and PhDs in the USA. ORDER NOW! Meet my deadline
	I have been having some troubling chest pain in my chest now and then for the past month.
	Sorry for the chest problem	Empathize 04/15/23 1:10 PM EDT
	Thanks. I appreciate that.
	When did the chest pain start?	Question 04/15/23 1:11 PM EDT
	I first noticed it earlier this month. I thought it might just be heartburn and it passed after a couple of minutes.
	How is the pain like	Question 04/15/23 1:13 PM EDT
	Well, it doesn’t hurt right now, but I have been having chest pain now and then for the past month.
	Where is the pain located?	Question 04/15/23 1:13 PM EDT
	When the pain happens, I feel it mostly in the middle of my chest, over my heart.
	Does the chest pain radiate?	Question 04/15/23 1:14 PM EDT
	The pain doesn’t radiate anywhere. It’s mostly just right in the middle of my chest.
	Do you have back pain?	Question 04/15/23 1:15 PM EDT
	I haven’t had back pain, no.
	How frequent are the chest pains?	Question 04/15/23 1:16 PM EDT
	Well, it has happened three times the past month. It usually goes away after about a couple of minutes.
	What relieves the chest pain?	Question 04/15/23 1:17 PM EDT
	I’m not sure. I think lying still seems to help a little.
	What makes the pain worse	Question 04/15/23 1:17 PM EDT
	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.
	can you rate the pain on a scale	Question 04/15/23 1:18 PM EDT
	I’d say maybe a . . . 5? It’s just really uncomfortable . . . like there’s nothing I can do about it. Right now it’s like a zero though.
	Have you taken any medications for the chest pain	Question 04/15/23 1:20 PM EDT
	No, not yet.
	Which medications do you take currently (Clarified to What medications do you take?.)	Question 04/15/23 1:21 PM EDT
	Yeah, let’s see, I take atorvastatin for cholesterol, lisinopril for blood pressure. . . Oh yeah, and I take fish oil too. I hear that’s good for your cholesterol. (Clarified to what medications I am taking.)
	Thats good for your cholesterol, continue taking it	Educate 04/15/23 1:22 PM EDT
	Good to know. Thank you. Focused Exam: Chest Pain, Brian Foster Shadow health transcript
	Any allergies	Question 04/15/23 1:23 PM EDT
	No, well . . . I’ve had a bad reaction to codeine before, but that is all I know of.
	Any history of chronic illness?	Question 04/15/23 1:24 PM EDT
	Besides a little high blood pressure and cholesterol, no.
	Have you done EKG test recently?	Question 04/15/23 1:24 PM EDT
	I had one about three months ago. They usually put one on me at my annual physical.
	What were the results of the EKG?	Question 04/15/23 1:25 PM EDT
	I don’t remember the actual results, but as far as I know, it was normal.
	Do you have a primary care provider?	Question 04/15/23 1:25 PM EDT
	Dr. Melinda Smith.
	Great	Educate 04/15/23 1:26 PM EDT
	Good to know. Thank you.
	When did you last visit your care provider	Question 04/15/23 1:26 PM EDT
	I had a physical about 3 months ago.
	Any palpitations?	Question 04/15/23 1:27 PM EDT
	I don’t think so. I haven’t noticed any.
	Any history of heart illness? (Clarified to Do you have a history of heart problems?.)	Question 04/15/23 1:27 PM EDT
	All I know is I have high blood pressure and cholesterol, but that’s pretty well-controlled by medicine as far as I know. (Clarified to if I have a history of heart problems.)
	Do you feel stressed?	Question 04/15/23 1:28 PM EDT
	Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest.
	I’m sorry about that	Empathize 04/15/23 1:28 PM EDT
	Thanks. I appreciate that.
	Do you have hypertension?	Question 04/15/23 1:29 PM EDT
	Yes, I supposedly have moderately high blood pressure.
	Do you exercise?	Question 04/15/23 1:29 PM EDT
	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.
	I’m sorry you’ve not been able to exercise	Empathize 04/15/23 1:29 PM EDT
	Thanks. I appreciate that.
	What is your typical diet	Question 04/15/23 1:30 PM EDT
	I try to stay conscious of my diet. You know, I watch the fat. I watch the sodium . . . but I’m a dyed-in-the-wool carnivore too. Steaks and burgers find their way in there every once in a while.
	Do you drink water regularly?	Question 04/15/23 1:30 PM EDT
	I usually drink water all day at work. At least four glasses, probably more.
	Do you smoke cigarette?	Question 04/15/23 1:31 PM EDT
	Nope, I had a lot of friends who did but I never started.
	Smoking is bad for the health	Educate 04/15/23 1:32 PM EDT
	Good to know. Thank you.
	Do you take alcohol? Focused Exam: Chest Pain, Brian Foster Shadow health transcript	Question 04/15/23 1:32 PM EDT
	Sure, but never more than two or three beers on a weekend.
	Do you feel fatigued?	Question 04/15/23 1:33 PM EDT
	I’m not more tired than normal.
	Any dizziness?	Question 04/15/23 1:33 PM EDT
	No, I haven’t felt dizzy.
	Do you have Angina?	Question 04/15/23 1:33 PM EDT
	I’ve never been diagnosed with angina.
	Do you have edema?	Question 04/15/23 1:34 PM EDT
	I haven’t noticed any swelling.
	Have you has blood clots?	Question 04/15/23 1:34 PM EDT
	Not that I know of.
	Any fever?	Question 04/15/23 1:35 PM EDT
	I haven’t had a fever, no.
	Do you cough?	Question 04/15/23 1:35 PM EDT
	I don’t have a cough.
	Any difficulty breathing?	Question 04/15/23 1:35 PM EDT
	My breathing’s fine.
	Any sore throat?	Question 04/15/23 1:35 PM EDT
	I haven’t had a sore throat in a long time.
	Do you have diarrhea?	Question 04/15/23 1:36 PM EDT
	I have, but it is very rare for me.
	Do you have constipation?	Question 04/15/23 1:37 PM EDT
	I haven’t had problems with that. I wish it were only that.
	Any heartburn?	Question 04/15/23 1:37 PM EDT
	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.
	Any family history of hear attack?	Question 04/15/23 1:37 PM EDT
	No, nobody had that.
	Have you been monitoring your blood pressure?	Question 04/15/23 1:38 PM EDT
	Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it.
	Measured vitals	Exam Action 04/15/23 1:39 PM EDT
	Tested blood pressure in left arm with cuff	Exam Action 04/15/23 1:39 PM EDT
	Tested blood pressure in right arm with cuff	Exam Action 04/15/23 1:39 PM EDT
	Measured vitals	Exam Action 04/15/23 1:39 PM EDT
	Inspected face	Exam Action 04/15/23 1:39 PM EDT
	Inspected for jugular venous distension: No jugular venous distention; JVP 3 cm above sternal angle	Exam Action 04/15/23 1:40 PM EDT
	Inspected anterior chest wall	Exam Action 04/15/23 1:40 PM EDT
	Inspected right side chest wall	Exam Action 04/15/23 1:40 PM EDT
	Inspected posterior chest wall	Exam Action 04/15/23 1:40 PM EDT
	Inspected left side chest wall	Exam Action 04/15/23 1:40 PM EDT
	Inspected left side of abdomen	Exam Action 04/15/23 1:40 PM EDT
	Inspected front of abdomen	Exam Action 04/15/23 1:40 PM EDT
	Inspected right hand: no visible abnormal findings	Exam Action 04/15/23 1:41 PM EDT
	Inspected left hand: no visible abnormal findings	Exam Action 04/15/23 1:41 PM EDT
	Inspected fingernails of left hand Focused Exam: Chest Pain, Brian Foster Shadow health transcript	Exam Action 04/15/23 1:41 PM EDT
	Inspected right hand: no visible abnormal findings	Exam Action 04/15/23 1:41 PM EDT
	Inspected left hand: no visible abnormal findings	Exam Action 04/15/23 1:41 PM EDT
	Inspected fingernails of right hand	Exam Action 04/15/23 1:41 PM EDT
	Inspected left leg	Exam Action 04/15/23 1:41 PM EDT
	Inspected right leg Focused Exam: Chest Pain, Brian Foster Shadow health transcript	Exam Action 04/15/23 1:41 PM EDT
	Inspected toenails on left foot	Exam Action 04/15/23 1:41 PM EDT
	Inspected toenails on right foot	Exam Action 04/15/23 1:41 PM EDT
	Inspected left leg	Exam Action 04/15/23 1:41 PM EDT
	Inspected right leg	Exam Action 04/15/23 1:41 PM EDT
	Inspected right leg for edema: No edema	Exam Action 04/15/23 1:42 PM EDT
	Inspected left leg for edema: No edema	Exam Action 04/15/23 1:42 PM EDT
	Checked capillary refill in fingernails	Exam Action 04/15/23 1:42 PM EDT
	Checked capillary refill in fingernails	Exam Action 04/15/23 1:42 PM EDT
	Checked capillary refill in fingernails	Exam Action 04/15/23 1:42 PM EDT
	Auscultated right carotid pulse: Bruit present	Exam Action 04/15/23 1:43 PM EDT
	Auscultated left carotid pulse	Exam Action 04/15/23 1:43 PM EDT
	Auscultated aortic area with the bell	Exam Action 04/15/23 1:43 PM EDT
	Auscultated aortic area with the diaphragm	Exam Action 04/15/23 1:43 PM EDT
	Auscultated pulmonic area with the diaphragm	Exam Action 04/15/23 1:43 PM EDT
	Auscultated pulmonic area with the bell	Exam Action 04/15/23 1:43 PM EDT
	Auscultated Erb’s point with the bell	Exam Action 04/15/23 1:43 PM EDT
	Auscultated Erb’s point with the diaphragm	Exam Action 04/15/23 1:43 PM EDT
	Auscultated tricuspid area with the diaphragm	Exam Action 04/15/23 1:43 PM EDT
	Auscultated tricuspid area with the bell	Exam Action 04/15/23 1:43 PM EDT
	Auscultated tricuspid area with the diaphragm	Exam Action 04/15/23 1:43 PM EDT
	Auscultated mitral area with the diaphragm	Exam Action 04/15/23 1:43 PM EDT
	Auscultated mitral area with the bell	Exam Action 04/15/23 1:43 PM EDT
	Auscultated breath sounds in anterior right upper lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in anterior left upper lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in anterior right middle lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in anterior left mid-chest (upper lobe)	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in anterior right lower lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in anterior left lower lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in posterior left upper lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in posterior right upper lobe	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in posterior left mid-back (lower lobe)	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in posterior right mid-back (lower lobe)	Exam Action 04/15/23 1:44 PM EDT
	Auscultated breath sounds in posterior left lower lobe	Exam Action 04/15/23 1:45 PM EDT
	Auscultated breath sounds in posterior right lower lobe	Exam Action 04/15/23 1:45 PM EDT
	Auscultated breath sounds in posterior left lower lobe on side	Exam Action 04/15/23 1:45 PM EDT
	Auscultated breath sounds in posterior right lower lobe on side	Exam Action 04/15/23 1:45 PM EDT
	Auscultated aorta in abdomen	Exam Action 04/15/23 2:12 PM EDT
	Auscultated right renal pulse	Exam Action 04/15/23 2:13 PM EDT
	Auscultated left renal pulse	Exam Action 04/15/23 2:13 PM EDT
	Auscultated right iliac pulse	Exam Action 04/15/23 2:13 PM EDT
	Auscultated left iliac pulse	Exam Action 04/15/23 2:13 PM EDT
	Auscultated right femoral pulse	Exam Action 04/15/23 2:13 PM EDT
	Auscultated left femoral pulse	Exam Action 04/15/23 2:13 PM EDT
	Auscultated right upper quadrant	Exam Action 04/15/23 2:13 PM EDT
	Auscultated left upper quadrant	Exam Action 04/15/23 2:13 PM EDT
	Auscultated right lower quadrant	Exam Action 04/15/23 2:13 PM EDT
	Auscultated left lower quadrant	Exam Action 04/15/23 2:13 PM EDT
	Auscultated over liver Focused Exam: Chest Pain, Brian Foster Shadow health transcript	Exam Action 04/15/23 2:13 PM EDT
	Auscultated over spleen	Exam Action 04/15/23 2:13 PM EDT
	Palpated right carotid pulse: Thrill, 3+	Exam Action 04/15/23 2:14 PM EDT
	Palpated right carotid pulse: Thrill, 3+	Exam Action 04/15/23 2:14 PM EDT
	Palpated PMI: Displaced laterally; brisk and tapping; less than 3 cm	Exam Action 04/15/23 2:15 PM EDT
	Palpated right brachial pulse: No thrill, 2+	Exam Action 04/15/23 2:15 PM EDT
	Palpated left brachial pulse: No thrill, 2+	Exam Action 04/15/23 2:15 PM EDT
	Palpated right radial pulse: No thrill, 2+	Exam Action 04/15/23 2:15 PM EDT
	Palpated left radial pulse: No thrill, 2+	Exam Action 04/15/23 2:15 PM EDT
	Palpated right femoral pulse: No thrill, 2+	Exam Action 04/15/23 2:16 PM EDT
	Palpated left femoral pulse: No thrill, 2+	Exam Action 04/15/23 2:16 PM EDT
	Palpated right popliteal pulse: No thrill, 1+	Exam Action 04/15/23 2:16 PM EDT
	Palpated left popliteal pulse: No thrill, 1+	Exam Action 04/15/23 2:16 PM EDT
	Palpated right tibial pulse: No thrill, 1+	Exam Action 04/15/23 2:16 PM EDT
	Palpated left tibial pulse: No thrill, 1+	Exam Action 04/15/23 2:16 PM EDT
	Palpated right dorsalis pedis pulse: No thrill, 1+	Exam Action 04/15/23 2:17 PM EDT
	Palpated left dorsalis pedis pulse: No thrill, 1+	Exam Action 04/15/23 2:17 PM EDT
	Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 04/15/23 2:17 PM EDT
	Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 04/15/23 2:17 PM EDT
	Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 04/15/23 2:17 PM EDT
	Palpated left lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 04/15/23 2:17 PM EDT
	Palpated right upper quadrant with deep pressure: No masses	Exam Action 04/15/23 2:18 PM EDT
	Palpated left upper quadrant with deep pressure: No masses	Exam Action 04/15/23 2:18 PM EDT
	Palpated right lower quadrant: with deep pressure: No masses	Exam Action 04/15/23 2:18 PM EDT
	Palpated left lower quadrant with deep pressure: No masses	Exam Action 04/15/23 2:18 PM EDT
	Palpated liver: Palpable 1 cm below right costal margin	Exam Action 04/15/23 2:18 PM EDT
	Palpated for spleen: Not palpable	Exam Action 04/15/23 2:19 PM EDT
	Palpated for right kidney: Not palpable	Exam Action 04/15/23 2:19 PM EDT
	Palpated for left kidney: Not palpable	Exam Action 04/15/23 2:19 PM EDT
	Tested skin turgor	Exam Action 04/15/23 2:19 PM EDT
	Percussed right upper quadrant	Exam Action 04/15/23 2:20 PM EDT
	Percussed left upper quadrant	Exam Action 04/15/23 2:20 PM EDT
	Percussed right lower quadrant	Exam Action 04/15/23 2:20 PM EDT
	Percussed left lower quadrant	Exam Action 04/15/23 2:20 PM EDT
	Percussed spleen	Exam Action 04/15/23 2:21 PM EDT
	Percussed for liver span: 7 cm in the mid-clavicular line Focused Exam: Chest Pain, Brian Foster Shadow health transcript	Exam Action 04/15/23 2:21 PM EDT

Title: Focused Exam: Chest Pain, Brian Foster Shadow Health Transcript

Introduction:
– Greeted Brian Foster.
– Asked about reason for visit.
– Brian Foster mentioned having troubling chest pain for a month.

Chest Pain Details:
– Brian Foster talked about chest pain starting earlier this month, initially thought it was heartburn.
– Pain located in the middle of chest, over heart.
– Pain doesn’t radiate, mainly stays in the middle of chest.
– No back pain experienced.
– Pain occurs about three times a month, lasts a few minutes.
– Physical activity seems to worsen the pain.
– Pain level around 5, uncomfortable.
– Lying still provides slight relief.

Medications:
– Brian Foster takes atorvastatin for cholesterol, lisinopril for blood pressure, and fish oil.
– Mentioned possibility of continuing fish oil for cholesterol.

Medical History:
– No allergies except a reaction to codeine.
– Only history of high blood pressure and cholesterol.
– Recent EKG done, believed to be normal.
– Primary care provider is Dr. Melinda Smith.

Lifestyle and Symptoms:
– No palpitations, no history of heart illness.
– Feeling anxious due to uncertainty about chest condition.
– Hypertension present, moderately high blood pressure.
– Used to exercise by cycling, but stopped after bike was stolen.
– Conscious of diet, occasionally eats steaks and burgers.
– Drinks water regularly, about four glasses at work.
– Non-smoker, aware of smoking’s negative impact.
– Moderate alcohol consumption.
– No increased fatigue, dizziness, angina, edema, or blood clots.
– No fever, cough, difficulty breathing, sore throat, diarrhea, constipation, or heartburn.
– No family history of heart attack.

Physical Examination:
– Various palpations and auscultations performed for pulse and organ assessment.
– No masses, tenderness, guarding, or distension observed.
– Liver palpable about 1 cm below right costal margin.
– Spleen not palpable.
– Liver span measured at 7 cm in mid-clavicular line.

Conclusion:
– Conducted thorough physical examination.
– Gathered detailed information about chest pain and medical history.

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Focused Exam: Chest Pain, Brian Foster Shadow health transcript