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

### input:
I am 31 years old and started having chest pains about 2 months ago I went to urgent care and they thought it was acid reflux I took medicine for heartburn and it never really got better 2 weeks later I went to ER and they did blood work EKG and chest X-ray everything came back fine and said it was anxiety then 2 weeks ago I went to my physician and he put me on lexapro Im uninsured and my chest is feeling a little better but now I have some pains in my wrist and hand but I didnt have a stress test and I keep telling myself I need 1 just to rule out some underlying heart conditions am I just freaking out or should I have a stress test and I do smoke cigarettes about half a pack a day

### output:

Thanks for your question on Chat Doctor. I can understand your situation and problem. Your symptoms are mostly due to stress, anxiety induced HERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Smoking causes further damage to sphincter and aggravate reflux more. So along with Chat Doctor.  1. Avoid stress and tension. Be relax and calm. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Go for walk after meals. 5. Keep 2-3 pillows under head in the bed to prevent reflux. 6. Quit smoking as soon as possible. This is very bad habit. Do all these for 1 month and if you are still not improve then go for stress test.