<s>[INST] My husband had a triple by-pass 10 weeks ago. These past few days he is complaining of severe back, shoulder pain and pain if he tries to take a deep breath. His BP, pulse rate, and temp are normal. The pain radiates to his chest but is not coming from his heart. Could he have pluerisy? [/INST] Hello, I had gone through the case and found that if there is doubt of pleurisy then go for Echo of lungs and find the cause. If no then go for vitamin D3 test AMD it might be only muscle spasm. So go for test then take treatment. If only muscle spasm then take mild painkiller and apply muscle relaxant gel and also take Vitamin D3 once a week for 3 months. Hope my answer will be effective for you. Thanks </s>