Transcript

Doctor: Good morning, Mr. Sharma. It's good to see you again. How have you been since our last appointment in January? Patient: Good morning, doctor. I've been alright for the most part. But over the last month, I've started experiencing some discomfort in my chest when I exert myself. Like walking fast, climbing stairs, or carrying groceries. Doctor: I see. Can you describe this discomfort? Is it sharp? Burning? Pressure-like? Patient: It feels more like pressure. Like a weight on my chest it usually lasts a few minutes and goes away when I sit or slow down. Doctor: Have you noticed any accompanying symptoms? Shortness of breath? Lightheadedness? Sweating? Or pain radiating to your arm or jaw? Patient: Yes. I do feel a little breathless. Especially if I push myself. No pain in the arms or jaw. Though. And I've had a few episodes where I felt a bit dizzy afterward. Doctor: Alright, thank you for sharing that. Let's take a look at your vitals first. Your blood pressure today is 142 over 88. Slightly elevated. Your pulse is regular at 82 beats per minute. And your oxygen saturation is 97%. Any changes in your medication or diet recently? Patient: I've been trying to reduce salt and walk 30 minutes daily. But I do sometimes forget my evening dose of amlodipine. Doctor: That could be contributing to the elevated blood pressure. And what about your diabetes? Were you monitoring your glucose levels? Patient: Yes. I check it every morning. It's usually around 110 to 120. I haven't started medication yet. Doctor: That's manageable for now. But we need to keep an eye on it. Coming back to the chest discomfort. Based on your symptoms, I'd like to run a few tests. Specifically an ECG. An echocardiogram. And a treadmill stress test. These will help us assess how your heart responds under physical exertion. Patient: Okay. Do I need to get them done today? Doctor: We'll schedule them within the next week. In the meantime, I'm going to make a few adjustments to your treatment plan. I'll increase your amlodipine dose to 10mg once daily and start you on a low-dose aspirin. 81mg per day. To reduce the risk of any clot formation. I'll also prescribe a statin to help lower your LDL cholesterol. Patient: That sounds like a lot. Will there be any side effects I should watch out for? Doctor: That's a fair concern. You might experience mild fatigue or muscle aches with the statin. But most people tolerate it well. The aspirin can occasionally cause gastritis. So I'll prescribe a gastroprotective medicine along with it. Let me know if you experience any black stools, stomach pain, or unusual bruising. Patient: Understood. Should I avoid any particular foods? Doctor: Yes. Continue your low-sodium diet. Reduce saturated fats. And increase intake of vegetables, legumes, and lean protein. Avoid smoking and limit alcohol. Hydration and consistent physical activity are important too. Preferably brisk walking. But don't overexert yourself until we complete the stress test. Patient: I'll try my best. What about follow-ups? Doctor: We'll see you again in two weeks once the test results are in. My team will call you to book the diagnostic appointments. In the meantime, if you experience severe chest pain, shortness of breath, or feel faint, please go to the emergency room immediately. Patient: Thank you, doctor. This was very helpful. Doctor: You're welcome. We'll stay proactive and make sure everything is under control. I'll have the nurse explain the prescriptions and testing schedule before you leave.