Question

When taking a history from the patient who is complaining of chest​ pain, a pertinent negative would​ include:

A. the absence of breathing difficulty.
B. the lack of a history of allergies.
C. the lack of prior heart attacks.
D. his taking nitro and ASA.

Answer 1

In the context of chest pain, a pertinent negative could be the absence of breathing difficulty, a common symptom of acute myocardial infarction. This absence is significant as it helps in the differential diagnosis process, which distinguishes between various medical conditions that share similar symptoms.

Step-by-step explanation:

When taking a history from a patient complaining of chest pain, a pertinent negative would include symptoms that are typically expected with certain diagnoses but are absent in the patient being examined. In this scenario, a pertinent negative could include the absence of breathing difficulty. Breathing difficulty, or dyspnea, is a common symptom associated with acute myocardial infarction (MI), also known as a heart attack. Patients with an acute MI often present with retrosternal chest pain, sometimes radiating down the left arm, particularly in males, along with shortness of breath, irregular heartbeat, nausea and vomiting, sweating (diaphoresis), anxiety, and fainting (syncope). However, in a differential diagnosis scenario, especially since symptoms can be shared with other conditions like anxiety attacks or indigestion, noting the absence of certain symptoms can be crucial. If a patient experiencing chest pain does not have breathing difficulty, this could help steer the differential diagnosis away from certain cardiac events.