<s>[INST] my husband 33yearsold obese had shoulder pain since 1week intermittently severe pain with swellingand cant lift left hand because of pain.he had severe chestpain n thought indigestion n admitted in hospital under observation for slightincrease cardiacenzymes and slight ecg variation.is it an attack or high bp n high cholesterol levels also creates such problems? [/INST] Chest pain radiating to arm is a classical symptom of Angina Sectors usually also associated with profuse sweating. Evaluation having showed variation in ECG suggestive of a heart attack (ST elevation) along with increased Cardiac enzymes is almost confirmatory of Myocardial Infarction (an ongoing heart attack). The next best step in case of persistent chest pain is to go through a Coronary Angiogram which will give a clear picture of the status of coronary arteries supplying the heart. Any blocks in these arteries if any will be detected and can be dealt with. If the chest pain has stopped, serial eggs and cardiac enzymes can be taken to confirm an MI (myocardial infarction) or heart attack in simple words, and then the doctor can proceed to do an angiogram or treadmill test based on the changes. High cholesterol levels might also play a part in clogging up the arteries and hypertension can also lead to damage to arteries and plaque formation. All these are additional risk factors if present in leading to a heart attack. </s>