Prepared by: Yogeswaran (Penang Medical College) MMI/2015/MMIMAID/PBL/MED/T.1 MMI MAID: MAKING AN INFORMED DECISION PROBLEM BASED LEARNING (PBL) SESSION DEPARTMENT: MEDICINE “AN ELEPHANT IS SITTING ON MY CHEST” TRIGGER 1 Mr. James, a 50-year-old man presented to the emergency department with one hour history of central chest pain while he was jogging. He says the pain is severe and radiates to his left arm. He describes it as an elephant sitting on his chest. He is sweating and feeling nauseous. He is not short of breath. In the week preceding this episode, he has been getting mild central chest pains. Each episode only lasted about 10 minutes and occurred during walking up stairs. These episodes of chest pain went away after resting. He has no significant past medical history. He was told that his cholesterol levels were a ‘little high’ on a routine health screen two years ago. He is not on any medications and has no known allergies. His father died of ‘heart disease’ at the age of 45. His mother is healthy. He smokes 20 cigarettes a day, and has been smoking since his early twenties. He drinks approximately between 10-20 units of alcohol a week.
MMI MAID: MAKING AN INFORMED DECISION PROBLEM BASED LEARNING
(PBL) SESSION
DEPARTMENT: MEDICINE
AN ELEPHANT IS SITTING ON MY CHEST
TRIGGER 1 Mr. James, a 50-year-old man presented to the
emergency department with one hour history of central chest pain
while he was jogging. He says the pain is severe and radiates to
his left arm. He describes it as an elephant sitting on his chest.
He is sweating and feeling nauseous. He is not short of breath. In
the week preceding this episode, he has been getting mild central
chest pains. Each episode only lasted about 10 minutes and occurred
during walking up stairs. These episodes of chest pain went away
after resting. He has no significant past medical history. He was
told that his cholesterol levels were a little high on a routine
health screen two years ago. He is not on any medications and has
no known allergies. His father died of heart disease at the age of
45. His mother is healthy. He smokes 20 cigarettes a day, and has
been smoking since his early twenties. He drinks approximately
between 10-20 units of alcohol a week.
