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

### input:
What to check out next. I have had chest pains, more of an ache, going on since an emotional event in February. The pains aren t necessarily induced by stress, as they happen more at night and position doesn t matter (sitting or laying down). They have gone into my back and down my left arm to twinge between my index and middle fingers as well as in my wrist. I have taken my inhalers before thinking it was related to asthma, no effect. I have taken an antibiotic for the full 10 days as doctors thought it was bronchitis, no effect. My BPs were up (160-158/102 -98) so I have been put on atenolol 50 mg to help. I have been battling high cholesterol for 12 years and recently went on a statin (zocor 20mg) for that. I am termed pre-diabetic with my lab results and my liver enzymes are noted to be high but said to be ok ? I have had a good EKG, good stress test (7 mets reached without issue) and clear cardiac cath but since the cath 2 weeks ago, I still get the chest pains but they are quick and almost like a zap. It can feel like my diaphragm is getting punched up into my heart/chest and goes away just as fast. Over the weekend I have had 2 sets of 3 zaps right in a row, like a pulse. And Thursday before last I had 12 such zaps to the center/left of center area of my chest where the first four zaps felt the strongest but the 4th zap being the strongest of the first four, then each faded but I counted 12 in all. (would that be a cluster?) I ve tried Prilosec OTC also to see if it was related to heartburn but that also had no effect. Could this be Printzmetal s angina?

### output:

Certainly this can be primeval angina. Instead of taking atenolol for your BP you should take calcium channel blocker like diltiazem or nifedipine, so it can take care of high BP and may resolve angina if it is primeval type. U should try to get ECG done during the episode. If it's a frequent episode then u can go ahead with holder monitoring so that detect the ECG changes associated with episodes.