<s>[INST] a week ago my 42 year old son suddenly experiened a pain in left shoulder blade and neck now through the week he has had tightness in his left chest where the heart is located and at the same time has pain in the left arm, neck and back shoulder and flank area of left back. No shortness of breath, sweating or nausea with this should he continue to think he has a pinched nerve or could it have something to do with his heart? [/INST] Hello, His symptoms are characteristic of heart disease-related to pain. So better to consult a cardiologist, and get done blood pressure monitoring, ECG, 2d echo, and stress test (trade mill test). If all these are normal, then no need to worry about heart diseases. Musculoskeletal pain is also possible. So tell him to avoid heavy weight lifting and strenuous exercise. Avoid movements causing pain. Apply warm water pad on affected areas. He can also take simple painkillers like paracetamol or ibuprofen. Don't worry, he will be alright, with all these. Hope I have answered your query. Let me know if I can assist you further.  </s>