Clinician: Hi, Mister Okafor, I am Doctor Lin. What brings you in today?
Patient: Hi doctor. I have had this burning feeling in my chest on and off for about three weeks. I figured it was heartburn.
Clinician: Tell me more about the burning. When does it happen?
Patient: Sometimes after a big dinner. But the last week or so, when I walk up the stairs at work, it gets tight in my chest and it goes up into my jaw. It goes away if I stand still for a few minutes.
Clinician: Any shortness of breath or sweating with it?
Patient: I get a little winded on the stairs. No sweating that I noticed.
Clinician: Have you had any pain at rest, or waking you up at night?
Patient: No, not at rest.
Clinician: What medicines are you taking right now?
Patient: Lisinopril, twenty milligrams, for my blood pressure. And I take ibuprofen most days, two or three tablets, for my knee.
Clinician: Do you smoke, and does anyone in your family have heart problems?
Patient: I quit smoking five years ago. My father had a heart attack when he was fifty eight.
Clinician: Okay. Your blood pressure today is one fifty two over ninety four, and your pulse is eighty. Your belly is soft and a little tender up high, and your lungs are clear.
Clinician: I think most of this sounds like acid reflux, and the ibuprofen can make that worse. Let us start omeprazole, twenty milligrams every morning before breakfast, and try to cut back on the ibuprofen.
Clinician: Avoid big meals late in the evening. I will see you back in four weeks to see how the burning is doing.
Patient: Okay, thank you, doctor.
