### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
All my life Ive had infrequent episodes of stabbing chest pains; the pain, anywhere between a 5-8 on a 1-10 pain scale, has lasted anywhere from 20 minutes to an hour or more. There doesnt seem to be triggers like spicy food or etc. Well, possibly stress? Im a 21 year old female and have had this happen to me infrequently throughout my life since elementary school age. Thanks in advance for your help. (Family history of heart disease, cancer, leukemia, high blood pressure/cholesterol. Also, I am 510 170 lbs.)

### output:

Hello! Welcome and thank you for asking on Chat Doctor! I carefully passed through your question and would explain that your symptoms don't seem to be related to any cardiac disorders. Coming to this point the main possible causes to consider would be: - musculoskeletal pain. Is the pain triggered by body movements or respiration? This could indicate possible musculoskeletal pain. - gastroesophageal reflux or esophageal spasms. This is less probable as your symptoms are not triggered by any specific type of food. - anxiety could mimic all this clinical situation. As your symptoms have been going on for a long period, I would exclude other serious causes. I would recommend making a trial: taking ibuprofen. If your symptoms are relieved by ibuprofen, this would indicate a musculoskeletal pain. Otherwise, if your symptoms are not relieved by ibuprofen, I would recommend trying alprazolam. The relief of your symptoms by alprazolam would indicate anxiety as the main cause of your symptoms. And at last, try an antacid or PPI (omeprazole, lansoprazole, etc.). The relief of your symptoms by any of these Chat Doctor.  Hope you will find this answer helpful! Kind regards, 