Chest Pain Hx
Chest pain Onset [text] prior to evaluation Onset while: [text] Associated Pain (0=none, 10=severe) Location: [text] Radiation: [text] Severity now (0-10): [text] Severity at worst (0-10): [text] Duration: [text] Characterized as: [text]. The pain is relieved with [text] [select value="no|YES"] <-- exertional pain [select value="no|YES"] <-- pleuritic pain Associated Symptoms: [select value="no|YES"] <-- nausea/vomiting [select value="no|YES"] <-- diaphoresis [select value="no|YES"] <-- shortness of breath Pertinent PMH [select value="no|YES"] <-- Coronary Disease [select value="no|YES"] <-- Cerebrovascular disease [select value="no|YES"] <-- Diabetes Mellitus [select value="no|YES"] <-- Peptic Ulcer or GERD [select value="no|YES"] <-- Chest injury or overuse Pertinent Medications: [select value="no|YES"] <-- Aspirin was taken today [select value="no|YES"] <-- Nitroglycerin Pitfalls: [select value="no|YES"] <-- unilateral leg swelling [select value="no|YES"] <-- recent prolonged travel, recent trauma, hypercoagulable state, hormonal therapy Cardiovascular risks are reviewed as follows: Family history of Premature CAD or CVA (age less than 55): [text] Tobacco use: [text] Hyperlipidemia: [text] Hypertension: [text] [checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"] reference: contributed by Dr. Scott Moses, creator/author of the [link url="http://www.fpnotebook.com" memo="FP Notebook Site"] Family Practice Notebook[/conditional]
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