Facilitator notes

Facilitator, please role-play this patient and allow the student/team to collect a focused history. The key elements are reported here, provide generic information when there is no applicable answer below.
After the role-play, provide the History handout to the player.

Kyle Jennar, 63 years old, non-Aboriginal or Torres Strait Islander.

Opening line: “I’ve been feeling terrible today! I’m completely exhausted and I’m struggling to catch my breath. I am at my wits’ end with this.”

This has started today, shortly after waking up. You’ve felt tired even while giving breakfast to your dog, Sully, and felt you had to slow down to catch your breath.

These episodes have occurred more and more frequently since the past three months. They’re quite debilitating.

Initially it was just once every fortnight, now you feel this tiredness coming on twice or three times a week. You thought you simply had some bad days, but now it is worrying you.

On the bad days, you get very short of breath during activities like playing bowls or walking your dog, and you need to stop and catch your breath.

During these episodes you sometimes feel lightheaded but have never experienced fainting, nausea, or chest pain.

You have noticed your heart racing sometimes during these episodes. If asked by the student, please tap out an irregular rhythm. You are currently feeling palpitations.

You are concerned that you might be about to have a heart attack, like your father did around your age.

Past medical history

You have been previously diagnosed with hypertension and gastroesophageal reflux. You take an ACE inhibitor, captopril, and omeprazole daily. You have no surgical history. You are allergic to latex.

Your father passed from a heart attack at 65 years old. Your mother is well. You have no siblings.

Lifestyle and social history

You work as an accountant and live with your partner Dylan.

You drink 4 glasses of white wine each night. You smoke 10 cigarettes per day and have for the last 15 years. You do not take any recreational drugs.

You eat an “alright” diet and don’t get much exercise.