<s>[INST] My friend has multiple symptoms of prinzmetal s angina. His family doc told him everything was normal, yet he continues to experience symptoms. As a last resort someone gave him some nitro pills and the chest pain subsided. His doctor has him on metoprolol and we have read that drug can increase the severity and frequency of the chest pain. Tonight he has mild chest pain and a headache that he claims is nearly debilitating and coming in waves across the left side of his head. He also claims his vision in the left eye is intermittently blurred with the headache. Please advise [/INST] Thanks for your question on Chat Doctor. I can understand your concern. No, metoprolol is not causing worsening of symptoms or chest pain in printzmetal angina. In fact, metoprolol is one of the treatment option for angina. Honestly speaking, I think your friend is having uncontrolled stress and anxiety related symptoms. Since his heart work up is normal, no need to worry about angina or other heart related symptoms. In my opinion, he should consult psychiatrist and get done counselling sessions. Try to identify stressor in his life and start working on its solution. He may need anxiolytic Chat Doctor.  Don't worry, with counselling and anxiolytic  </s>