<s>[INST] My 20 yr old nephew has been having chest pains & a racing heart rate every time he eats certain foods.  He was told in the ER the 1st time this happened that he was very sensitive to caffeine, so he stopped drinking things with it in it.  The pains kept occurring though from fried food mostly.  Tonight he went to a Mexican restaurant & got the racing heart/chest pains again.  Now he is having chills even though he has his apt at 80 degrees.  Any ideas on what may be causing this & how to help until he can get to a Dr. tomorrow?  Thanks. [/INST] Hello!Welcome and thank you for asking on HCM!His symptoms could be related to an infection (gastro-enteritis). Gastritis could explain the fact that his symptoms are triggered by spicy food. For this reason, I would recommend bringing him to the ER for a careful physical exam, a chest X ray study and some blood lab tests (complete blood count, PCR, ESR for inflammation). Hope you will find this answer helpful!Kind regards, Dr. Iliri </s>