Chest Pain and Dyspnea: Diagnostic Reasoning in Primary Care

Ms. L.T. is a 61-year-old female presenting with intermittent chest tightness and exertional dyspnea for 3 weeks. History:

• PMH: Hypertension, tobacco use (30 pack-years), anxiety

• Medications: Amlodipine 5 mg daily • Symptoms: Chest discomfort radiating to jaw, relieved

by rest Vitals:

• BP: 156/88 mmHg • HR: 96 bpm

Initial Findings: • EKG: Nonspecific ST-T changes • SpO₂: 95% on room air

Student Assignment Requirements 1. Pathophysiology (25%)

• Compare and contrast ischemic vs non-ischemic chest pain mechanisms

• Explain cardiopulmonary causes of dyspnea • Address anxiety overlap

2. Assessment & Differential Diagnosis (35%) • Focused cardiac and pulmonary exam • Prioritized differential diagnosis • Identification of life-threatening conditions • Decision-making for ED referral vs outpatient

management 3. Pharmacology & Initial Management (30%)

• Acute and chronic pharmacologic considerations • Antihypertensive optimization • Risk reduction strategies • Follow-up testing and referrals

4. APA & Evidence Integration (10%)

REQUIREMENTS:

APA FORMAT CHECK GRAMMAR AND SPELLING