<s>[INST] Hello doctor, I have had fluctuating elevated blood pressure for three to four years between 135-180/85-112 mmHg. I did not take any medication. I have had episodes of sudden fainting, pain and burning in the chest. When tested, ECG was fine. But four days ago, it was different. I had felt extremely fatigued for two days, then I felt pain in my center and left side of my chest. My hands seemed numb. I had periodic episodes of cold sweats on the back of my head and neck, as well as a dull ache in my left upper shoulder. The heaviness was there also. This stayed off and on all evening, during which I took two baby Aspirin, which provided a little relief. The next day, I was still very tired and my chest was sore. The pain was sporadic in my chest, like a quick stinging pain. When I tried to do anything, it would try to start again. During this time, my blood pressure reached its highest at 167/112 mmHg. The third day I felt better. I am currently on Zoloft 100 mg once daily. Does this sound like a heart attack? I was terrified. [/INST] Hello. Your symptoms are not typical of a heart attack. They seem to indicate musculoskeletal pain or inflammation. Is the pain triggered by deep breathing or body movements? This would be another argument in favor of a musculo-skeletal pain. The increase in blood pressure values during these episodes is a normal physiological reaction to the pain. So, there is nothing to worry about. Anyways, an exercise cardiac stress test would help reassure you that nothing bad is going on. Regarding your blood pressure values, I would recommend you to measure your blood pressure frequently during a week and write those values down. If blood pressure values are frequently above the normal ranges (140/90 mmHg), antihypertensive therapy may be needed. Some blood lab tests are also necessary to investigate for other possible metabolic causes that may lead to this symptomatology: For more information consult a cardiologist online --> </s>