Case study Eleanor Vance – 68-year-old female with exertional
chest pressure Ihuman focused on cardiovascular assessment
(angina/ischemia)
HPI Table – Eleanor Vance (Exertional Chest Pressure)
Patient Response (Eleanor Symptom
# Question (Clinician Asks) Clinical Significance
Vance) Category
I’ve been having chest pressure
1 What brings you in today? Chief complaint General
when I walk.
2 When did this start? A few weeks ago. Onset Cardiac
3 Was it sudden or gradual? Gradual. Chronic process Cardiac
4 Has it been getting worse? Yes, a bit worse recently. Progression Cardiac
5 How often does it happen? Almost every time I exert myself. Frequency Cardiac
6 How long does it last? A few minutes. Duration Cardiac
7 Where do you feel it? In the middle of my chest. Location Cardiac
8 Does it move anywhere? No, it stays there. No radiation Cardiac
, Patient Response (Eleanor Symptom
# Question (Clinician Asks) Clinical Significance
Vance) Category
Any pain to your arm or Less severe
9 No. Cardiac
jaw? ischemia
How would you describe
10 Like pressure or heaviness. Classic angina Cardiac
it?
11 How bad is it (1–10)? Around a 6. Severity Cardiac
12 What brings it on? Walking uphill or exertion. Exertional angina Cardiac
Does walking uphill trigger
13 Yes, definitely. Increased demand Cardiac
it?
14 Does stress bring it on? Sometimes. Stress-induced Cardiac
15 Does it happen at rest? No, not usually. Stable angina Cardiac
16 What makes it better? Resting. Relief pattern Cardiac
How quickly does it go
17 After a few minutes of rest. Classic angina Cardiac
away?
, Patient Response (Eleanor Symptom
# Question (Clinician Asks) Clinical Significance
Vance) Category
Have you taken
18 No. Untreated Cardiac
medication for it?
19 Does anything worsen it? Activity. Trigger Cardiac
Has it lasted longer
20 Yes, yesterday it did. Red flag Cardiac
recently?
Is it happening more
21 Yes. Progression Cardiac
often?
Did the last episode feel
22 Yes. Instability concern Cardiac
worse?
Do you feel short of
23 Yes, with the pressure. Cardiac dyspnea Respiratory
breath?
24 Short of breath at rest? No. Severity Respiratory
25 Do you feel tired easily? Yes. Reduced perfusion General
chest pressure Ihuman focused on cardiovascular assessment
(angina/ischemia)
HPI Table – Eleanor Vance (Exertional Chest Pressure)
Patient Response (Eleanor Symptom
# Question (Clinician Asks) Clinical Significance
Vance) Category
I’ve been having chest pressure
1 What brings you in today? Chief complaint General
when I walk.
2 When did this start? A few weeks ago. Onset Cardiac
3 Was it sudden or gradual? Gradual. Chronic process Cardiac
4 Has it been getting worse? Yes, a bit worse recently. Progression Cardiac
5 How often does it happen? Almost every time I exert myself. Frequency Cardiac
6 How long does it last? A few minutes. Duration Cardiac
7 Where do you feel it? In the middle of my chest. Location Cardiac
8 Does it move anywhere? No, it stays there. No radiation Cardiac
, Patient Response (Eleanor Symptom
# Question (Clinician Asks) Clinical Significance
Vance) Category
Any pain to your arm or Less severe
9 No. Cardiac
jaw? ischemia
How would you describe
10 Like pressure or heaviness. Classic angina Cardiac
it?
11 How bad is it (1–10)? Around a 6. Severity Cardiac
12 What brings it on? Walking uphill or exertion. Exertional angina Cardiac
Does walking uphill trigger
13 Yes, definitely. Increased demand Cardiac
it?
14 Does stress bring it on? Sometimes. Stress-induced Cardiac
15 Does it happen at rest? No, not usually. Stable angina Cardiac
16 What makes it better? Resting. Relief pattern Cardiac
How quickly does it go
17 After a few minutes of rest. Classic angina Cardiac
away?
, Patient Response (Eleanor Symptom
# Question (Clinician Asks) Clinical Significance
Vance) Category
Have you taken
18 No. Untreated Cardiac
medication for it?
19 Does anything worsen it? Activity. Trigger Cardiac
Has it lasted longer
20 Yes, yesterday it did. Red flag Cardiac
recently?
Is it happening more
21 Yes. Progression Cardiac
often?
Did the last episode feel
22 Yes. Instability concern Cardiac
worse?
Do you feel short of
23 Yes, with the pressure. Cardiac dyspnea Respiratory
breath?
24 Short of breath at rest? No. Severity Respiratory
25 Do you feel tired easily? Yes. Reduced perfusion General
