Asking the Right Question
Asking the Right Question
Should a physician ask a patient, "Have you had any chest pain?", the doctor is likely to miss the patient's angina pectoris.
Many patients, of course, do refer to the symptom of angina pectoris as "chest pain." But many patients do not. Patients may refer to the chest discomfort of angina pectoris as tightness, indigestion, pressure, strangling, etc.
A smart patient of mine advised me some years ago to teach my trainees to ask patients, "Do you ever feel anything in the chest that bothers you that you have not felt before?" That particular patient characterized his angina pectoris as a "sternal whisper." As a result, the symptom had been ignored by several physicians.
Once the patient chooses a word to describe his or her angina, the physician should use the same word. I had a patient who called his angina pectoris "a wad in the chest when I walk." On follow-up I was careful to ask, "How is the wad in your chest?"
Should a physician ask a patient, "Have you had any chest pain?", the doctor is likely to miss the patient's angina pectoris.
Many patients, of course, do refer to the symptom of angina pectoris as "chest pain." But many patients do not. Patients may refer to the chest discomfort of angina pectoris as tightness, indigestion, pressure, strangling, etc.
A smart patient of mine advised me some years ago to teach my trainees to ask patients, "Do you ever feel anything in the chest that bothers you that you have not felt before?" That particular patient characterized his angina pectoris as a "sternal whisper." As a result, the symptom had been ignored by several physicians.
Once the patient chooses a word to describe his or her angina, the physician should use the same word. I had a patient who called his angina pectoris "a wad in the chest when I walk." On follow-up I was careful to ask, "How is the wad in your chest?"
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