A delayed diagnosis and poor notes make this case indefensible


Case history
A 59-YEAR-old man consulted his GP with a history of waking the previous morning with intense retrosternal pain without radiation. A glass of water had settled the pain. He had been sweaty and nauseous at the time.

The patient said he had had a normal stress test as part of his executive health check just two years earlier. He appeared well and was not in pain. The GP recorded only “developed pain epigastric region 48 hours ago after lunch”, diagnosed oesophageal