History of presenting complaint
Also called HPC, History of present illness, HPI
The history of presenting complaint is the detailed story of the main problem: onset, character, timing, triggers, relieving factors and associated symptoms.
Why it matters in a workup
Write it as a timeline. A reader should be able to see when the problem started, how it has changed and what has been tried.
Include the relevant negatives here, such as the red flags you asked about and the answers.
Put it into practice
- Order events by time
- Record onset, character, triggers and relieving factors
- Include the red flags asked about, present or absent
Frequently asked questions
Should negatives go in the history of presenting complaint?
Yes, the ones that bear on the complaint. A recorded negative shows you asked and helps the reader judge the differential.
General guidance on clinical documentation, not advice about any individual patient and not legal advice.
Glossary
Look up related terms
- Presenting complaintThe presenting complaint is the main problem that brought the patient in, recorded in a short phrase and ideally in the patient's own words.
- Red flagsRed flags are history or examination features that raise the likelihood of a serious cause and call for prompt action or further assessment.
- Review of systemsA review of systems is a structured set of questions about each body system, asked to find symptoms the patient did not mention.