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

### input:
Hi I had a liver function test 4weeks ago and have been told it is over 200 with colesterol at 7.7 my lft  2 years ago was 96 and colesterol was 4.5 I get intermittent left (my left)shoulder pain and every 6weeks approx. I get a bad stomach ache followed by hot n cold sweats and feels like I would imagine a heart attack would feel. It leaves me bed ridden for the rest of the day. I get occasional indegestion and am always tired. Thanks for reading this Lesley

### output:

Hello Lesley!  Normally gall bladder Infections present with epigastric pain and are referred to tips of the shoulders, and cholesterol rise too but as you said pain is intermittent, so it is more like a chronic history. Then you said perspiration with anticipation of heart attack? How old are you ? Above 40? I am suspecting 2 things1) more likely it looks like chronic cholecystitis (your gall bladder) 2) inferior heart MI also presents this way so here is what we gonna do-Do an ECG to rule out cardiac involvement, followed by echo and MR scan of the heart if required if that area is clear-then we need to clear hepatobiliary suspicion. To do that i advise-U/S abdomen and pelvis-serum amylase, lipase, amylase to lipase ratio, urinary amylase, plain X-ray abdomen App view followed by a CT scan if required, serum calcium (both ionized and total) Bag and HCV.Meanwhile area yourself for symptoms-get Proton pump inhibitor like omeprazole etc. 40 mg once a day an hour before the meal or 3 hours after it-Take some antispasmodics like Spasfon-use less fatty meals-lose weight-Get a broad spectrum antibiotic if you have a fever am sure you will have your problem fixed with it Good luck and get well soon :)Regards Doctor Shaft Ullah Khan Patient is my family