When the patient can't tell you their symptoms
Today I had a follow-up appointment with a young adult male with severe intellectual disabilities. He is barely verbal.
Several weeks ago, his caregiver told me that this young man often pointed to his chest and would say “hurt” or “heart”; they weren’t sure which.
He also seemed to have gotten pickier about his food, and would literally pick at the food on his plate as if examining it. His appetite was definitely down, but he hadn’t lost any weight yet.
Jimmy is young and slender, not a smoker, and has no cardiovascular disease in his