Mary has a consultation at the RACP clinic. Utilising a nmemonic such as OLDCART will allow nurse Frances to carry out a thorough clinical assessment.
Onset of pain: On exertion, not at rest
Nurse: What brings the chest pain on?
Mary: When I am walking up a hill with my shopping or going upstairs.
Location: Central chest, radiating to left upper arm
Nurse: Can you tell me specifically where you have the pain?
Mary: Just in the middle of my chest and it goes down my left arm.
Duration: 2-5minutes
Nurse: How long does it usually last?
Mary: A couple of minutes.
Characteristics: Tightness /heaviness
Nurse: How would you describe it?
Mary: Its like a tight band going across my chest but sometimes it feels a bit heavy as well.
Associated signs & symptoms: Shortness of breath and sweating
Nurse: Does it make you feel breathless, sick or sweaty or do you feel any palpitations?
Mary: It does make me feel short of breath and a bit sweaty.
Relieving factors: Rest
Nurse: Does anything take it away?
Mary: If I stop what I am doing for a couple of minutes it goes away.
Treatment/therapy to date: GTN
Nurse: Does your GTN spray help?
Mary: Yes, normally I was able to take 1 puff but now I am having to take 2 puffs and use more frequently.
Pulse point
Remember that anginal symptoms can vary in location. See additional information or the introduction to Module 3 to see those.
Page last reviewed: 03 Jun 2020
