- Nature of the chest pain?
Why: Angina is generally described as "heavy", "crushing" or "gripping".
- Intensity of the chest pain?
Why: Angina can range from a mild ache to a most severe pain that provokes sweating and fear.
- Location of the chest pain?
Why: Angina is usually behind the sternum.
- Radiation of the chest pain?
Why: Angina may radiate to the arms, jaw, throat or back.
- Aggravating factors?
Why: Angina usually is aggravated by exercise, emotion, after a meal or in cold weather.
- Relieving factors?
Why: Angina usually fades quickly with rest or with nitroglycerine spray.
- Past medical history?
Why: High blood pressure, High cholesterol and Diabetes increase the risk of angina and heart attacks.
- Cigarette smoking?
Why: increase the risk of angina and heart attacks.
- Exercise history?
Why: lack of exercise increases the risk of angina and heart attacks.
- Family history?
Why: Of angina or early heart attacks.
- Have you experienced any chest pain/chest pressure?
Why: Chest pain and chest pressure/tightness are the hallmarks of angina.
- Can you describe your chest pain/chest pressure?
Why: The description that you give to your Health Professional is very important in helping to diagnose its cause. Anginal chest pain can be experienced and described in a wide variety of ways, though the majority of patients describe it as a diffuse pain/tightness which is not easily identified as coming from any particular single point on the chest. Pain which is felt in an easily and readily identifiable location is more likely to be not angina pain. Angina pain may additionally be felt in one or both arms, the neck and jaw. It may sometimes be mistaken for reflux pain/indigestion/heartburn/dyspepsia.
- When did this chest pain start, or, when do you experience it?
Why: Typical anginal pain may be brought on my exertion (stable angina), on lying down (decubitus angina), or even at rest (unstable angina or Prinzmetal Angina). It is also very important for you to tell your Health Professional when the first time you experienced angina was, as this may give some indication of the underlying cause and its severity. The frequency of anginal pain is another important detail not to be missed as it may give some idea of the severity of your current condition.
- Does anything make your episodes of angina better or worse?
Why: If there are any particular factors (such as rest) which relieve your angina, then they may be important in determining its cause. Similarly, anything which brings it on or makes it worse is important for helping to formulate a management plan for your condition.
- Have you ever had a "heart attack"/myocardial infarction, any other heart diseases or heart problems?
Why: As anginal pain is caused by inadequate supply of oxygen via your blood to your heart muscle, it is important for you to tell your Health Professional if you have ever been diagnosed with any other heart diseases.
- Have you ever been diagnosed with anemia?
Why: This can be a cause of angina.
- Has anyone else in your family ever had any heart problems or heart disease?
Why: Many common (such as ischemic heart disease) and uncommon heart diseases (such as hypertrophic obstructive cardiomyopathy) can be inheritable, and if anyone in your family has been diagnosed with a heart disease then your Health Professional may approach your case in a slightly different manner.
- Have you ever been diagnosed with diabetes, impaired glucose tolerance, obesity, hypertension, or hypercholesterolemia?
Why: Along with ischemic heart disease/vascular disease$, these conditions are all components of a broader syndrome called Syndrome X. The present of some of these conditions can predispose to other conditions which make up the Syndrome X, and may need to be managed in a slightly different manner.
- Has your angina changed at all recently?
Why: Any changes in the pattern of angina that you are experiencing may indicate a worsening of your ischemic heart disease, or may increase your risk of myocardial infarction.
- Have you ever been diagnosed with any thyroid diseases such as hyperthyroidism? -Hyperthyroidism can increase the amount of "work" that your heart has to perform, and may bring on episodes of angina
- Have you lost weight recently, been unable to handle cool temperatures (cold intolerance), noticed any tremors, or experienced any problems with your vision/eyes?
Why: These can all be indications of hyperthyroidism, and may partly explain why you have been experiencing angina.
- Have you ever had any heart investigations, such as electrocardiography, echocardiography, a thallium scan, or angiography?
Why: These are all common investigations which can be ordered for heart diseases such as ischemic heart disease and angina. Some of them are more invasive than others and so repeating them can have risks. If you have had any of these performed before then it is important for you to communicate the results of those investigations to your current treating Health Professional, as any past results can highlight recent changes and so assist in formulating a management plan for your current condition.
- Are you taking any medications, and have you taken any before?
Why: It is important for your health professional to know which medications you are currently taking, and which ones you have taken in the past. Knowing this can assist them to prescribe the appropriate medication/s for your current condition. Any allergies (including those to medications) are also important to mention.
- Can you try and tell me how bad the chest pain is?
Why: This can give an indication of the underlying disease process, and may help to differentiate between a myocardial infarction and angina.
- Have you experienced any shortness of breath (dyspnea), light-headedness, nausea or "clamminess" recently?
Why: These are all symptoms which can assist in the diagnosis of the underlying cause of your chest pain.
