Question

A middle-aged man is admitted to the hospital complaining of substernal chest pain. Describe the specific health information to be collected from the patient concerning his pain symptom by applying the PQRST approach to aid the diagnosis of angina pectoris.

Answer 1

PQRST assessment:

Provocation factors:

Ask the patient about what factor worsen the pain. Angina occur with activities that involve exertion or emotional stress. Smoking, exercise may also cause angina. This activity will make myocardium for more demand for oxygen so this will aggravate the pain.

Quality of pain :

Ask the patient to describe the pain. How was his pain. Angina pain will be dull ache, sharp stabbing, substernal, squeezing, tightness, pressure, burning.

Burning pain often mistook as heartburn or indigestion.

Region or radiation pain :

Patient is asked about the location of pain.

Angina pain may radiate to shoulder, arms, jaw, neck or back.

Severity :

Pain severity is assessed by numerical pain scale range from 0-10 and ask the patient to rate the pain level according to the severity. This method is a subjective data and again the reading is taken and this will help whether the pain increased or getting worsen.

Angina pain intensity is unaffected by inspiration and expiration.

Timing :

Ask the patient about

When does the pain usually occur? Morning, afternoon or night. Angina pain more likely occur in morning.

How long does the pain last? Pain usually last less than 5 minutes upto 15-20 minutes.

Does the pain start gradually and get worsen. Angina pain develop slowly and quickly.

Would you describe the pain whether it is mild, moderate or severe. Angina pain usually describe as mild or moderate.

What you will do to relieve pain? Angina pain may relieved by nitroglycerin or rest.