<s>[INST] I have frequent chest pains and strong palpitations. The pains are hard to describe and they move around.  Sometimes it feels like squeezing and pressure.  Other times it feels like a lump in my chest.  Sometimes its sort of a burning sensation like its in the muscles.   I exercise regularly and never have a problem while I am exercising.  I cant tolerate even a small amount of alcohol because a couple of hours later I start with strong palpitations that keep me up all night.  I dont know what other things may be triggering this.  I have stopped all caffiene.  This has been going on for a couple of years.  Any idea what this may be.  I am a 41 year old female and I weigh 145.  I used to be very overweight.  I took a lot of diet and energy supplements over a period of ten years.  Could this be related to my problem? [/INST] Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of stress and anxiety induced HERD (gastroesophageal reflux disease) is more. Your palpitations are due to stress and anxiety. Your chest tightness, pressure, worsening symptoms with alcohol etc. are due to HERD. So we should first treat your stress and anxiety. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic Chat Doctor.  For HERD, follow these steps. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Take pantoprazole tablet on empty stomach. Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>