Observe the SOCRATES mnemonic during the GP’s consultation with Bryan.
S – GP: You have told me the discomfort is in your lower chest, upper abdomen
Bryan again puts his hand across his chest
O – GP: and that it occurs when you are climbing stairs.
C – GP:You have also said that it feels like a dull ache or a burning feeling.
R – GP: does your discomfort go anywhere else
Bryan: Well funny you should ask it can go to my arms and on some occasions to my legs
A – GP: Does your discomfort make you feel breathless
Bryan: Yes and I can also feel slightly nauseated.
T – GP: How long does your symptoms take to go away
Bryan: It makes me stop what I am doing and takes a couple of minutes to go away.
E – GP: Are there any things that would make your symptoms worse or better
Bryan:If I eat a heavy meal I am aware that if I exert myself I can get chest pain. The only other time I get it is when I climb stairs or I am rushing to pub to meet my pals
S – GP: If 1 is the least and 10 the worst pain you have ever had, how would you describe the pain?
Bryan: 4.
Pulse point
It is important to take a full clinical history to avoid mis-diagnosis.
Patients with stable angina should have the diagnosis made, where possible, following a carefully obtained clinical assessment. Clinical history is the key component in the evaluation of the patient with angina: often the diagnosis can be made on the basis of clinical history alone.
Page last reviewed: 01 Jun 2020
