Chest Pain in a 49-yr-old Woman

Physical Examination

  • General appearance: Appears anxious and in some pain. No cyanosis or respiratory distress.

  • Vital signs:
  • Temperature 36.8° C
  • Pulse 107 beats/min
  • BP right arm 130/72 mm Hg
  • Respirations: 16/min
  • O2 saturation 96% on room air

  • Skin: No lesions or rashes.

  • HEENT: Mucus membranes moist, no oral lesions, patent nares.

  • Pulmonary: Lungs clear to auscultation bilaterally. No crackles or wheezes.

  • Cardiovascular: Elevated rate, regular rhythm. No murmurs, rubs, or gallops. No tenderness to palpation. No jugular venous distention. Normal carotid pulse.

  • Gastrointestinal: bdomen nontender and nondistended with normal bowel sounds.

  • Genitourinary: Uterus palpated just below the umbilicus. No blood in vaginal vault.

  • Musculoskeletal: No joint deformity, full range of motion without pain. Lower extremities: no swelling, erythema, or tenderness.

  • Neurologic: Cranial nerves intact; muscle strength and sensation intact throughout.

  • Mental status: Alert and oriented to person, place, and time.