<s>[INST] Several months ago I experienced excruciating chest pain after swallowing some milk, ? esophageal spasm, and then passed out, for several minutes? while sitting in a recliner, went to ER and they could not give me a diagnosis, EKG normal. Now I have those pains regularly and some palpitations and shortness of breath with those. Do I need a cardiac workup or is it still the ? spasms causing my heart to do this? I am 45 y female. My father died at 50 of massive heart attack. [/INST] Hello! Thank you for asking on Chat Doctor! I carefully passed through your question and would explain that a cardiac arrhythmia can not be excluded considering the palpitations and shortness of breath. That is why I would recommend consulting with your attending physician for a careful physical exam and some tests: - a cardiac ultrasound- an ambulatory 24-48 hours ECG monitoring in order to exclude possible cardiac arrhythmia. - thyroid hormone levels for possible dysfunction. Regarding the esophageal spasms, they are not related to any cardiac causes. I recommend performing a fibrogastroscopy to investigate for the possible causes. Anxiety could also play an important role in all this clinical scenario. You should take it into consideration too. Hope to have been helpful! Kind regards,  </s>