Which history gathering method would you use to get more detailed information about a patient's chest pain?

• A. Old Cart
• B. Opqrst
• C. Soap
• D. Fan method

Answer: (B)

When gathering history for chest pain, using a focused, structured approach that prompts all the critical details helps you differentiate potential cardiac causes from non-cardiac ones and guides urgency and follow-up. The OPQRST method does exactly that by guiding you to ask about:

• Onset: when did the pain start, and what were you doing at the time?

• Provocation/palliation: what makes it worse or better? any relief with rest or nitroglycerin?

• Quality: how does the pain feel—pressure, squeezing, burning, sharp?

• Region/location and radiation: where is the pain, and does it spread to the shoulder, arm, jaw, back, or neck?

• Severity: how bad is it on a scale from 0 to 10?

• Timing: is it constant or intermittent, and how long does each episode last or how has it changed over time?

Including associated symptoms such as sweating, shortness of breath, nausea, or lightheadedness adds important context to assess risk. This structured history is preferred because it systematically captures the nuances that help triage and determine the next steps in care.

Old Cart is a similar approach, but OPQRST provides a bit more emphasis on the key nuances of chest pain timing and quality. The Fan method isn’t a standard, widely used chest-pain history approach, and SOAP is a documentation format rather than a history-gathering mnemonic.