<s>[INST] If a female, 37 year old have hypertension 170/90 and with chest pain when admitted to ER and twitching in the muscles and chilling all over the body, physician has requested heart enzymes test, CPK found high, troponin -ve , but the  patient still have the chest pain even after treatment. What is the probable prognosis [/INST] Hi, Chest pain occurring without associated symptoms like Radiation Of Pain to the Neck, Back, Jaw, Arms, Sweating, Breathlessness is less likely to be of cardiac origin. You also mention that you had twitching of Muscles & a Chill all over the body could also mean Stress, Anxiety. Your BP would have transiently shot up. Have you been on any regular medications for Increased BP? A few Lifestyle Modifications like Exercising Regularly, with some Yoga would help you control your anxieties, if these measures fail you could get a consult and start some anxiolytic. Your diet should be Salt Restricted, Low Fat Diet. Incase you have these symptoms quite frequently then please get your Thyroid Function Tests done along with 24 hour Ambulatory BP monitoring. </s>