<s>[INST] yes i have a nephew who has chest pain that starts out as though someone has stabed him in the chest with pipe and says it spreads out like a cob web also he tingles and numbs in his left arm  an bout passes out eyes roll back in his head they say his heart is fine  he does have low blood sugar hypro glysemic [/INST] Thanks for your question on Chat Doctor. I can understand your concern. We should rule out cardiac cause first for his symptoms. Because left sided chest pain with left arm numbness is seen commonly with heart diseases. So get done ECG and 2d echo. If both are normal then no need to worry about cardiac diseases. Hypoglycemia can cause similar symptoms due to nerve damage. Vitamin b12 deficiency can also cause similar symptoms. So get done blood sugar estimation and vitamin B 12 level. And if deficiency then you need supplements. Hope I have solved your query. Wishing good health to your nephew. Thanks. </s>