<s>[INST] I have been having a dull pain in my left arm for about the past 3 days. This morning I felt ill and vomited once and have spent the rest of the day laying down. I had open heart approx. 3 years ago, and don t want to spend all evening in a waiting room, to just be told to follow up with my Dr. Monday. advice? [/INST] Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, we should first rule out heart diseases in your case. Your symptoms like ill feeling, left arm uneasiness etc. are common symptoms of heart diseases. You also had open-heart surgery 3 years back. So better to get done ECG, 2d echo, stress test (trade mill test) and coronary angiography (if required) to rule out heart diseases. If all these are normal then no need to worry about heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>