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

### input:
I have been having chest pains on the left side for about 5 days. I already take Prilosec for my stomach, I have problems with pain in middle under ribcage for a while, no tests done but doc said could be ulcer. I have tried gas pills, malaoxx and of course still on the Prilosec. I went to the e.r. yesterday and blood work, ekg, and chest xray was fine. they gave me a concoction that should have made my stomach feel better if that s what it was, I think malloxx and lidocaine. it still hurts and I don t think I have pulled anything. I do feel like I have reflux in my throat at times but I have had no relief and now I am having tingling in my fingers, which I have had before. I also have had problems with swelling of my joints for a while now, been tested for lupus and ra which were negative. not sure where to go from here since I have no insurance for a lot of testing. main worry I have is that I am not having a heart attack. I am 34 yrs old and I have been trying to quit smoking for a while. I smoke about a pk a day and have for 20 yrs. scary. I don t know what to do.

### output:

Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, you should get done stress test (trade mill test). You are a heavy smoker since long time, so you are definitely at risk of heart attack. Sometimes ECG in resting condition can be normal. But when body is in exertion (stress), ECG may show changes. And hence to rule out this stress test is needed. So get done stress test. If this is normal then no need to worry about heart diseases. Smoking is also a risk factor for HERD (gastroesophageal reflux disease). Smoking causes laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause central chest pain. So better to quit smoking as soon as possible. Along with antacids, avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Avoid stress and tension. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.