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

### input:
Hello, I am a 53 year old African American. 4 months ago I have been experiencing chest pain so I went to the emergency room they ran tests on me ultrasound stress test on me, the Dr told me my heart runnig 35 cents my left valve is not working good.so here referred me to a specialist and put me on a whole lot of medication. so I went to the heart specialist they told me that I m going to need a pacemaker cuz my heart is only running a 35 dut he going to see if the medicine going to work first... My BPM is 120 today and I am so tired all the time!! I was at Pizza Hut four days ago getting a salad and I fell off leash sharp pain in my chest enough of this running down my left arm for about 2 minutes that is so nice of breath!! I call my doctor it up and he made me appointment for August 6 come in to get checked 10 days since I had my episode.. is there any way that I can know if they can do anything for me then just lay here in the bed all the time tired 24 hours a day

### output:

Thanks for your question on Chat Doctor. In my opinion you are having cardiac disease. And most probably coronary artery disease. Risk factors in your case are1. Heart function is very low only 35%.2. Heart rate very high (tachycardia)3. Age more than 30.4. Recurrent left sided chest pain which is radiating towards left arm. So get done 2D Echo and TMT (Trade Mill Test) to rule out heart disease. Also get done coronary angiography to rule out coronary artery disease (CAD) as chances of CAD are very high in your case.