POLE · HOCM / Collapse

Patient Details

Name: Felicity / Freddy Pole
Age: 35 years
Opening statement: "I really didn't want to bother you doctor but my husband insisted that I came"

Clinical Details – Part 1 (Collapse)

If asked further: “I collapsed yesterday but it was all over and done in a minute so I really think everyone is making a fuss.”

Open questions — give freely:

Yesterday playing squash with an old friend; ~15 minutes in felt peculiar for an instant then blacked out. On coming round momentarily muddled then back to usual self. Wanted to continue; friend refused and recommended seeing a doctor. Refused ambulance; friend drove home. Within a minute conscious and wanting to get up. Apart from sore right shoulder (from the fall), felt fine since. Here at insistence of partner and friend.

Only if asked directly:

Witness account (only if student asks what third party saw): Friend said you were sprinting after the ball, crumpled and hit the floor; appeared unconscious, a little blue in the face; lying very still; friend thought you were not breathing
Not incontinent; did not bite tongue (only if asked specifically)

Patient Perspective (ICE)

Ideas: Does not know what happened. Hot in squash court — wonders if just fainted (recovered so quickly).

Concerns: Not worried — odd things happen sometimes, that’s life.

Expectations: Doctor to check blood pressure and say everything is fine.

Past Medical History

Age 10: Appendicectomy
Age 11: Exercise-induced asthma
Age 20: Left tibia & fibula fracture (football) — treated surgically (ORIF)

Medication

Salbutamol inhaler 2 puffs PRN (usually half a dozen puffs before exercise)
No allergies

Family History

Paternal grandfather died in 40s of a “heart attack” — no other information known.

Social History

2 bottles of wine/week; couple of G&Ts at weekend
Never smoked
Married 2 years (together since university); two children (10-year-old boy, 7-year-old girl)
Self-employed textile designer; highly respected; work with major manufacturers; travel to Italy, France, China
Partner part-time self-employed journalist; does much of house/childcare
Enjoys golf and squash; outgoing, sociable

Demeanour

Outgoing, cheerful and optimistic.

Information for the Student – Part 1

Name: Felicity / Freddy Pole · Age 35
PMH: Appendicectomy (10) · Exercise-induced asthma (11) · L tibia/fibula # ORIF (20)
Medication: Salbutamol 2 puffs PRN
Recent: 2 years ago: life insurance medical

Part 2 – Second Consultation (After Specialist)

GP referred to cardiologist at local private hospital. Specialist was a bit off-hand; arranged heart scan. Specialist has written; patient does not understand abbreviations and is worried by “a bit tricky really.” Will bring the letter to show GP.

Letter content (patient brings this):
Dr Careless, Expire Private Hospital, Cemetery Road, Bardston
“Dear Mrs/Mr Pole, I have received the result of your ECHO. It shows that you have HOCM which is a bit tricky really. I am going to get my secretary to send you another appointment, but it will not be until I return from a two-week cardiology conference. I suggest you see your GP who I am sure will answer any questions that you may have while you wait for my return. Kind regards, Dr Charlie Careless”

Practice has not yet received a copy of this letter nor one from the consultant.

Primary Care Block · University of Buckingham