<s>[INST] hello. I have a sharp, stabbing pain in the center of my chest that come and goes. I also feel a dull pain in the center of my shoulder blades in my back, I have a resting heartrate of 104. im a 38 year old black female weighing 179 a 5 1 . I have also been have weakness and a pain I cannot really describe in my left arm from arpit to thumb, iwas thinking pericarditis and planned to go so my dr but I didn t get to call in bwfore they closed. can you enlighten me as to what may possibly be going on? I live 45 min away from nearest hospital. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of ischemic heart disease(coronary artery disease-CAD) is more. Paricarditis is unlikely cause for chest pain. But you should consult emergency room an Chat Doctor.  These will rule out both pericarditis and CAD. If both are normal then no need to worry much. Your symptoms are mostly due to stress and anxiety.  So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>