<s>[INST] hi, i've been having sharp shooting pains near my heart, i also have tension headaches, and pains on my upper left back side. and pains on my left arm. i went to the doctor he made check ups and he said its not heart attack relates its spasms... please advise [/INST] Hello,Does this pain increases on activity or on deep breathing, is it associated with tingling or numbness.    Considering your cardiac work up is negative, there is possibility of gastritis and reflux for heart pain. Avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Eat lots of green leafy vegetables, and fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg before breakfast once a day for 2 weeks. For shoulder and arm pain, there is likelihood of cervical pain, due to compression of nerves between spine. Does this pain increases on neck movement, is it associated with tingling, numbness in arm or any neck trauma, if yes then it supports the diagnosis. Then he'll need x cervical spine AP/ Lat view and further may need MRI. Till the time he can have tab Neurobion forte once a day which is a nerve vitamin.   Lastly I would suggest you undergo treadmill test to rule out heart disease for sure.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode </s>