<s>[INST] my name is frank chiedozie I am having this pain in my chest area, it a sharp pain, looks like someone is pinching me with a needle. its on and off. Secondly,i perceive the odour of blood from my gullet, I have gone for ECG but was diagnose of AV Block 1,but the pain have refused to go despite taking pain killers. [/INST] Thanks for your question on Chat Doctor. Since you are having first degree AV block, your pain can be due to cardiac cause. So get done 2d echo to rule out cardiac cause. If this is normal then get done vitamin B 12 level as needle pricking pain can be seen in B 12 deficiencies. If deficit then supplement should be started. If B 12 is normal then mostly you have anxiety related needle pricking pain. So avoid stress and anxiety. </s>