<s>[INST] Hello, Doctor.  I am having a tightening feeling in my chest area--above my stomach--in the mornings just after I wake up.  I will be awake for just 4 or 5 seconds and I feel a sort of squeezing feeling, as if my blood pressure is trying extra hard to rise.  I am 50, female, dont smoke, I weigh about 143, and I exercise fairly hard 3 times a week. I have low blood pressure--sometimes in the 90s on top and 50s-60s on the bottom. I never feel faint or dizzy or have chest pains. When I get out of bed following this tightening, Im not dizzy or lightheaded.  What do you think this might be? [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Possibility of gastritis or HERD (gastroesophageal reflux disease) is more likely for your chest tightness. But since you are premenopausal female, we should first rule out heart related diseases for your chest discomfort because heart diseases are common in this age. So get done ECG and 2d echo. If both these are normal then no need to worry about heart diseases. Gastritis and HERD can cause similar symptoms due to acid reflux. So take pantoprazole tablet on empty stomach. Avoid hot and spicy food. Avoid junk food.  Chat Doctor.  </s>