<s>[INST] just recently i had severe crushing chest pain that lead to difficulty of breathing. i was gasping for breath and as a result went in for admission in an acute care facility. the doctor diagnosed it as costochondritis, however, i have doubts as my blood pressure during the episode shoot up to 220/160? i requested to be tested for cardiac enzymes CKMB and TROPONIN I and both are normal? what do you think? will my blood pressure really shoot up to such high? thanks [/INST] Hello!Welcome on HCM!Regarding your concern, I would explain that it is normal to have higher blood pressure values during pain, physical or emotional stress. From the other hand, these values of blood pressure are really high, and further investigations are needed to determine any other possible causes. For this reason, I would recommend consulting with your doctor and performing further tests: - thyroid hormone levels for thyroid dysfunction- a chest X ray study- urinary metanephrines for possible pheochromocytoma- an abdominal ultrasound- blood electrolytes for possible imbalance. - kidney and liver function testsYou should discuss with your doctor on the above issues. Meanwhile, I would recommend some lifestyle modifications to help maintain a normal blood pressure: - reduce salt and caffeine intake- perform a lot of physical activity (walking, aerobics, etc.)- reduce weight if you are overweight. Hope you will find this answer helpful!Kind regards, Dr. Iliri </s>