<s>[INST] Hello.  I have been having constant pain in my upper left chest, neck, and upper back for 8 months.  EKG, schest x-ray were normal.  Echocardiogram showed mild MVP.  24- hour holter showed frequent sinus tachycardia.  Primary doctor thinks it is fibromyalgia.  I am 32 year old female.  The only other problems I have are IBS and frequent headaches. [/INST] Hai, consant pain in your case is due to fibromyalgia related with cardiac problem of mitral valve prolapse(MVP), that too with varied sinus tachycardia, in that case it is very good on your part to start with beta-blockers like metoprolol, to control the heart rate added with anxiolytic like alprazolam, (small doses)this sort of radiating chest pain responds very well to centrally acting Chat Doctor.  </s>