The history begins with your description of your symptoms. When they began and how they have changed over time. Once you’ve initially presented these symptoms, your doctor will ask you more detailed questions that can flesh out crucial details that may distinguish a number of different causes.
What makes your symptoms better? What makes them worse? If you are experiencing pain, does it start in one place and radiate to another area? What type of pain is it (squeezing, sharp, crampy, burning or achy)?
This question can be challenging for some to answer. To many, pain is just pain. If you haven’t experienced a variety of different types of pain, it might be hard to distinguish the different types. It’s not unlike being an inexperienced wine taster and not being able to distinguish such subtleties.
Language and culture also influence your description.
Pain due to gastroenteritis, periods and labour are described as crampy. Pain from the passage of kidney and gall stones is typically colicky. Angina or chest pain from narrowed coronary arteries is typically – but not always – squeezing.
With angina, discomfort may radiate into the throat and neck or to either arm. Here typical exacerbating and alleviating factors are very important. Angina typically comes on with anything that increases the work of the heart, such as exertion (exercise) and anxiety – in short, physical or emotional stress.
Are there other symptoms associated with your primary symptom?
Nausea or queasiness is commonly associated with angina. In some cases, it may be the only symptom. Patients may experience nausea with exertion and acute stress without the typical chest pain.
That’s why – to you and your doctors – history is so important.
Next: the doctor’s inquisition – why we ask questions the way we do.