OET letter for a chest pain or angina patient: what to include in a discharge letter
In an OET Nursing letter about a patient discharged after chest pain or angina, state the purpose in the opening (for example, continued monitoring by the GP or practice nurse), then give the reason for admission, the key test results with dates, any new or changed medicines, and exactly what the reader should do next. Leave out background that does not affect follow-up, and copy every dose, result and instruction exactly from the case notes.
What the reader needs to know
A discharge letter after chest pain or angina is a handover. The reader, often a GP or practice nurse, needs to know why the patient was admitted, what was found, what changed and what happens next. Most of the case notes will be accurate but not all of it will be relevant. Your job is to choose the information the reader will act on. See how to select case notes for the general method.
Before you write, ask: "What will this reader do after reading my letter?" The answer shapes the whole letter, and it is what the Purpose criterion is about.
What to include and what to leave out
| Usually include | Usually leave out or shorten |
|---|---|
| Reason for admission and date | Detailed timeline of every hour in the emergency department |
| Diagnosis or working diagnosis, as written in the notes | Results that were normal and do not affect follow-up |
| Key results with dates (for example, the ECG finding, a blood test that confirmed or ruled something out) | Old history unrelated to the heart |
| New, stopped or changed medicines | Medicines that are unchanged and not relevant to the plan (unless the task asks) |
| Lifestyle factors the notes link to the plan (for example, smoking cessation support) | Hobbies or social details that do not affect care |
| Follow-up appointments, tests and who arranges them | Your own clinical opinion or advice |
| What the patient has been told to do if the pain returns, as stated in the notes | Generic health education not in the notes |
The test is relevance to the reader, not importance in general. A smoking history matters if the notes say the patient was referred to a quit service; a past knee operation usually does not.
A suggested paragraph plan
- Opening: who the patient is, why you are writing and what you want the reader to do.
- Admission: presenting symptoms, key results and the diagnosis.
- Treatment and changes: medicines started or changed, procedures if any.
- Patient factors: understanding, risk factors and social situation that affect follow-up.
- Requests and closing: appointments, monitoring and any action for the reader.
This order follows the reader's needs. You can merge paragraphs 3 and 4 if the notes are short. For more on structure, see Organisation & Layout.
Worked example (invented case)
Case notes (extract):
- Mrs Hana Lindqvist, 62, retired librarian
- Adm 3 Sept: central chest tightness on walking uphill, relieved by rest after ~10 min
- ECG: no acute changes. Troponin x2 normal
- Exercise stress test 5 Sept: ST changes at moderate exercise → stable angina (cardiology)
- Started: aspirin 100 mg daily; atorvastatin 40 mg nocte; GTN spray PRN
- Smoker 15/day; agreed referral to quit service
- Lives with husband; walks dog daily
- Educated re GTN use and when to call ambulance – verbalised understanding
- D/C 6 Sept. Cardiology OPD 6 wks. GP: review BP and lipids in 4 wks
Letter body (extract):
Dear Dr Mensah,
Re: Mrs Hana Lindqvist, aged 62
I am writing to inform you that Mrs Lindqvist was discharged home today after investigation of chest pain, and to request that you review her blood pressure and cholesterol in four weeks.
Mrs Lindqvist was admitted on 3 September with central chest tightness on walking uphill, which was relieved by rest. Her ECG showed no acute changes and two troponin tests were normal. An exercise stress test on 5 September showed changes at moderate exercise, and cardiology diagnosed stable angina.
She has been started on aspirin 100 mg daily and atorvastatin 40 mg at night, and has been prescribed a glyceryl trinitrate (GTN) spray to use when required. She has been taught how to use the spray and when to call an ambulance, and she was able to explain this back to staff.
Mrs Lindqvist smokes 15 cigarettes a day and has agreed to a referral to a smoking cessation service. She has a cardiology outpatient appointment in six weeks.
Why it works: the request appears in the opening, the results are grouped with their dates, and the medicines are written in full. Her former job and dog walking are left out because they do not change the plan. Every dose and result comes from the invented notes.
Useful phrases
- "She was admitted on [date] with [symptom], which was relieved by [rest / medicine]."
- "Investigations showed …" / "Two troponin tests were within normal limits."
- "She has been commenced on …" / "Her [medicine] dose has been increased to …"
- "She has been educated about … and was able to explain this back to staff."
- "I would be grateful if you could review her … in [time]."
For more ways to end the letter, see OET closing paragraph examples.
Common mistakes
- Hiding the request. If the GP must review blood pressure, say so in the opening, not only at the end.
- Listing every result. A list of normal blood values makes the letter longer without helping the reader. See Conciseness & Clarity.
- Copying "PRN", "nocte" or "D/C" into the letter. Write them in full. See OET writing abbreviations.
- Changing the diagnosis. If the notes say "stable angina", do not write "heart attack" or "heart disease". Use the notes' words.
- Adding clinical advice. Do not tell the GP which tests to order beyond what the notes say.
For writing medicines accurately, see how to write medications in an OET letter, and for a related letter type, see the heart attack and cardiac rehab letter guide.
Practise and check
Practise a timed letter at /writing/, or check a letter you have written to get an estimated grade, a mark for each of the six criteria and line-by-line corrections. medEmu is an independent practice tool for OET Writing for Nursing; its grades are estimates, and it is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance and not clinical advice; all patients, medicines, results and plans are invented for practice, and a real letter must follow the case notes. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.