Play the video and listen to the conversation. Use the reflective questions (can be found at the top of the page) to establish a first impression of what the conversation is about, and what the problems or learning points are.
Note 1: If you would prefer to see the script without additional symbols, click on the 'Normal Script' below
Note 2: Go to the link CA transcription symbol key to see an explanation of the symbols
73 DR: What did you do in the past? Was it your job that sent you up ladders?
74 PT: Yes I run a building business with my wife you see, 50 years ago this year
75 DR: Right ok right
76 PT: That’s when we founded it.
77 DR: It’s a long time!
78 PT: Yes it is!
79 DR: It’s a long time erm in terms of your your general health though, you’ve no history of high blood pressure?
80 PT: Well, yes I do suffer a bit of blood pressure but that’s controlled
81 DR: Right ok so so you’re on some medication?
82 PT: Ye- Yes
83 DR: Ok, I think the nurses have written down that medication can I just check that with you (opens notes), they’ve written down you’re on Enalapril
84 PT: That’s right
85 DR: Is that the only drug that you are on?
86 PT: Yes apart from a sort of Gaviscon?
87 DR: Because you’ve had some heartburn?
88 PT: Yes that’s right, a bit and some Paracetamol if I you know get a backache
89 DR: OK, but you’ve never had a heart attack in the past or a stroke
90 PT: ah No no no
91 DR: No asthma or any problems with your lungs
92 PT: No
93 DR: No? And no amm previous history of strokes
94 PT: Not me no (Dr looks at the Pt)
95 DR: No, any family history of anything important we need to know about?
96 PT: Well you know you’ve mentioned stroke, my father had a had a bad one.
97 DR: uhm
98 PT: 30 years ago now
99 DR: (nodding) And did he survive that or?
100 PT: No, Well he did have another one about 6 months later and that finished him off, yeah it was sad.
101 DR: That finished him (nodding) I know it is sad what about what about your mum is she
102 PT: Oh no she’s alive and well
103 DR: She’s well
104 PT: She’s fine. Yes (smiles)
105 DR: Ok that’s good. Does she live nearby?
106 PT: Yes she’s in some sheltered accommodation
107 DR: Ok
108 PT: Just just at Histon there,
109 DR: Right
110 PT: She’s fine yes
111 DR: All right so you are in a fast irregular heart rhythm, which is probably what you are feeling when you felt that palpitations and making you feel emm a bit puffy? It is also maybe causing a bit of a strain on the heart, which is why you feel that chest tightness right? Or it could be that you’re feeling the heart working hard, which is why you feel a bit tight across the chest. Apart from the shortness of breath and the palpitations is there anything else that’s been going on recently? Or anything else that’s worrying you?
112 PT: (shakes head) No apart from this sort of feeling a bit strange and funny anxious.
113 DR: Right ok, let’s go back to that, when you said strange it sort of suggested to me it was more anxiety, is it? Did you feel light headed? Or is it you were about to collapse?
114 PT: No no, I was just feeling uptight, and I I’m not usually feeling like this, sort of tense.
115 DR: Right. When you look like that you almost put an angry face on, it’s not it’s not anger, it’s just more
116 PT: No no
117 DR: It’s a scare is it erm you being scared about what’s going on? Or…
118 PT: Not even that really, no I just sort of feeling a sort of tense, can’t sort of
119 DR: And you don’t know where that comes from?
120 PT: No
73 DR: What did you do in the past? Was it your job that sent you up ladders?
74 PT: Yes I run a building business [with my wife [you see, 50 years ago [this year=
75 DR: [right [ok [right
76 PT: =that’s when we [founded it.
77 DR: [It’s a long time!
78 PT: Yes it is!
79 DR: It’s a long time. .hhhhh em::: (1.58) in terms of your:: your general health though, you’ve no history of high blood pressure?
80 PT: Well, yes I do suffer a bit of blood
pres[sure but that’s [controlled
81 DR: [right [ok So so you’re on some medication?
82 PT: Ye- Yes
83 DR: Ok, I think the nurses have written down that medication can I just check that with you .hhhh ((opens notes)), they’ve written down you’re on Enalapril:::
84 PT: That’s right
85 DR: Is that the only drug that you are on?
86 PT: Yes apart from a sort of Gaviscon (?????)
87 DR: Because you’ve had some heartburn?
88 PT: Yes that’s right, a bit=an::d some Paracetamol if I you know get a backache
89 DR: OK, but you’ve never had a heart attack in the past or a stroke
90 PT: ah No no no
91 DR: No asthma or any problems with your lungs (0.30)
92 PT: No
93 DR: No? And no:: amm previous history of strokes (0.97)
94 PT: Not me no ((Dr looks at the Pt))
95 DR: No. .hhh Any family history of anything important we need to know about?
96 PT: We::ll you know you’ve mentioned stroke, my father had a::: had a ba::d one.
97 DR: uhm (1.37)
98 PT: 30 years ago now
99 DR: ((nodding)) ⁰hum⁰ (.) .hhhh (1.08) And did he survive that↑ or::?
100 PT: .hhh no Well he did have another one about 6 months later and that finished [him off, yeah it was sad
101 DR: [that finished him ((nodding)) I know it is sad (0.85) what about what about your mum (.) is she::: (0.88)
102 PT: Oh no she’s alive and well=
103 DR: =She’s well=
104 PT: =she’s fine. [Yes ((smile))
105 DR: [ok that’s good. Does she live nearby?
106 PT: yes she’s in some sheltered accommodation
107 DR: ⁰Ok⁰
108 PT: just::: just at Histon there,
109 DR: ⁰right⁰
110 PT: she’s fine yes
111 DR: All right so- (1.93) you are in a fast irregular heart rhythm, which is probably what you are feeling when you felt that palpitations and making you feel emm a bit puffy? It is also maybe causing a bit of a strain on the heart, which is why you feel that chest tightness (0.78) right? Or it could be that you’re feeling the heart working hard, which is why you feel (.) .hhh a bit tight across the chest .hhhhh (0.59) Apart from the shortness of breath (.) and the palpitations (0.62) is there anything else that’s bee:::n (0.63) going on recently? [Or anything else that’s worrying you?
112 PT: [((shakes head)) hhhh. No apart from this sort of feeling a bit strange and funny [anxious.
113 DR: [Right ok, let’s go back to that, when you said strange it sort of suggested to me it was more anxiety, is it? Did you feel light headed? Or is it you were about to collapse? (0.94)
114 PT: No no, I was just feeling uptight, and I I’m not usually feeling like this, sort of tense.
115 DR: Right. When you look like that you almost put an angry face on, it’s not it’s not anger, it’s just more:::
116 PT: [No no
117 DR: [It’s a sca:: Is it erm you being scared about what’s going on? Or…
118 PT: Not even that really, no I just sort of feeling a sort of tense, can’t sort of
119 DR: And you don’t know where that comes from?
120 PT: No
The video is taken from UK Clinical Communication Council video bank.