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Consult: Cardiology for Chest Pain

Call the on-call cardiology fellow about a patient with concerning chest pain, justifying the need for an urgent consult.

  1. 1
    Briefing
  2. 2
    Simulation
  3. 3
    Feedback

How This Works

This is an interactive phone call simulation. You'll speak with Dr. Carter in a realistic clinical communication scenario.

1. Start Call

Click "Start Call" when you're ready. Speak naturally as you would on a real call.

2. Have the Conversation

10 minutes to complete the call. The AI responds in real-time to what you say.

3. Get Feedback

End the call when finished. You'll receive AI-powered feedback on your communication.

💡 Tip: Speak clearly and at a natural pace. If you need a moment to think, it's okay to pause briefly - just as you would in a real conversation.

Briefing Details

Consult Briefing

Your Objective

You are the hospitalist physician caring for a patient with concerning chest pain. The initial workup is inconclusive, and you believe the patient warrants an urgent cardiology consultation. Your goal is to call the on-call cardiology fellow, Dr. Carter, and effectively communicate the case using the SBAR framework. Be prepared to present the case clearly, state your "ask" directly, and answer the fellow's questions.

Patient: Robert Jones, 55M

  • MRN: 789123
  • Room: 721
  • Code Status: Full Code
  • Allergies: NKDA

Case Summary & Data

History: 55M with a history of hypertension and hyperlipidemia presented to the ED with 3 hours of substernal chest pressure. The pain is non-exertional, 6/10 severity, and ongoing.

Pertinent Exam/Vitals:

  • Vitals are stable: BP 140/85, HR 75, RR 16, SpO2 98% on RA.
  • Exam is unremarkable. No JVD, clear lungs, no murmurs.

Initial Workup:

  • EKG: Normal sinus rhythm, no ST elevation, but there are new 1mm ST depressions in the lateral leads (I, aVL, V5, V6).
  • Labs: First troponin is negative (<0.01). CBC and BMP are normal.
  • Imaging: Chest X-ray is clear.

The Clinical Question

You have a patient with ongoing chest pain and dynamic EKG changes, but a negative initial troponin. This is a high-risk clinical picture for unstable angina or an evolving NSTEMI.

Your "Ask": Your specific question for the cardiology fellow is: "Given the ongoing pain and new EKG changes, does this patient need to go for an urgent cardiac catheterization tonight, or can we manage medically and repeat labs/EKGs?"

Learning Objectives

Optional prep details

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Optional Pre-Call Knowledge Check

Optional self-check before you start

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After completing this scenario, you will be able to:

  • Apply the SBAR framework to structure an urgent verbal consultation request for a patient with undifferentiated chest pain.
  • Synthesize key clinical information to justify the need for specialist evaluation despite an inconclusive initial workup.
  • Anticipate potential questions from the cardiology fellow and prepare concise, data-driven responses.

In the SBAR framework, which component involves clearly stating your primary concern and what you believe is happening with the patient?

When justifying an urgent consult for chest pain with an inconclusive workup, which piece of information is most compelling to convey to the consultant?

Which of the following findings in a patient with chest pain is the strongest indicator of a high-risk Acute Coronary Syndrome (ACS), even with a normal initial ECG?