OET Writing practice · Medicine
Worsening exertional chest pain – cardiologist
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your referral letter in 40 minutes, about 180–200 words in the body.
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Case notes
MEDICINE — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 07/09/2026 You are a GP at Hollybrook Surgery, 9 Mill Road, Ashcombe. Patient: Mr Kwame Asante, DOB 04/02/1968 (58 yrs) Social background: - School caretaker, full-time; job involves carrying equipment and climbing stairs - Married, lives with wife and youngest daughter (19) - Smoker, 20 cigarettes/day since age 18 (approx. 40 pack-years) - Alcohol approx. 6 units/week. Enjoys watching football Family history: - Brother: myocardial infarction, age 52 - Mother: type 2 diabetes, died age 79 (stroke) Medical history: - Hypertension (2018), ramipril 5 mg daily - Type 2 diabetes mellitus (2020), metformin 1 g BD - Gout, last flare 2025, allopurinol 100 mg daily - Seasonal hay fever, cetirizine 10 mg PRN - NKDA Consultation notes: 03/08/2026 - c/o central chest tightness × 6 weeks when climbing stairs at work or walking uphill - Tightness radiates to L arm, lasts 3–5 min, settles with rest. No pain at rest or at night - Mild SOB during episodes. No palpitations, no syncope - O/E: BMI 31. BP 154/92, HR 76 reg. HS normal, no murmurs. Chest clear. No ankle oedema - ECG: sinus rhythm, rate 74, no ST/T-wave changes - Plan: FBC, U&E, lipids, HbA1c, TFT. Aspirin 75 mg daily, GTN spray PRN - Advised to call 999 if pain at rest or lasting >15 min - Smoking cessation discussed; pt not ready to quit 17/08/2026 (results) - Hb 146 g/L (normal), eGFR 74 mL/min, TFT normal - Total cholesterol 6.6 mmol/L, LDL 4.3 mmol/L - HbA1c 66 mmol/mol (Feb 2026: 58 mmol/mol) - Episodes 3–4×/week; GTN relieves within 2 min - Started bisoprolol 2.5 mg daily and atorvastatin 80 mg nocte - R knee ache after gardening; advised simple analgesia 07/09/2026 - Symptoms more frequent (5–6×/week), now also after walking approx. 200 m on the flat; worse on cold mornings - Using GTN 1–2×/day. Still no rest pain - Reduced smoking to 10/day; referred to local stop-smoking service - Pt worried about brother's heart attack; wants to keep working - O/E: BP 138/84, HR 62 reg. ECG unchanged - Tolerating new medication; mild tiredness Assessment: - Probable stable angina, worsening despite anti-anginal therapy Plan: - Referral to cardiology for assessment and further investigation (e.g. CT coronary angiography) - Increase bisoprolol to 5 mg daily - Continue metformin; diabetes review in 3 months - Safety-netting re unstable symptoms reinforced Writing Task: Using the information in the case notes, write a letter to Dr Helena Marsh, Consultant Cardiologist, Rapid Access Chest Pain Clinic, St Aldhelm's Hospital, 40 Cathedral Road, Ashcombe, referring Mr Asante for further assessment and management. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this referral letter
- The reader has never met the patient. State the reason for referral, and how urgent it is, in the first paragraph.
- Select the history, findings and investigation results that support the referral, and group them by topic rather than by date.
- End with what you are asking the reader to do, and any action you have already taken.
Members also get the model answer, the note-selection table and task-specific tips for this task.