Which elements are included in the OPQRST mnemonic used to collect chest pain history?

• A. Onset, Location, Quality
• B. Onset, Provocation, Quality, Radiation, Severity
• C. Onset, Provocation/Palliation, Quality, Radiation, Severity, Timing
• D. Onset, Severity, Timing

Answer: (C)

Think of OPQRST as a checklist that captures how chest pain behaves over time. Onset tells you when the pain began and whether it started suddenly or gradually, which helps gauge urgency. Provocation/Palliation asks what makes the pain worse or better—exercise, stress, rest, or medications like nitroglycerin—so you can distinguish cardiac from non-cardiac causes. Quality describes the sensation (pressure, tightness, sharpness, burning), which provides clues about the affected tissues. Radiation asks whether the pain travels to the jaw, neck, shoulder, arm, or back, a feature more common with cardiac origins. Severity rates how intense the pain is, guiding triage and monitoring. Timing records how long the pain lasts, its frequency, and any pattern, which helps differentiate ongoing ischemia or recurrent angina from transient issues. Together these six elements give a complete, practical chest pain history; some alternative lists omit timing or palliation or radiation, making them less comprehensive for guiding evaluation and management.