Brief Answer: If you are able to type in here, please elaborate. Detailed Answer: Hi, A chest pain that is very severe enough to cause anxiety, increased perspiration, nausea, vomiting, breathing disturbances and so on need immediate medical attention. Therefore if the pain is very severe I would suggest you to visit the ER right now. If you are unable to judge the severity as simple test would be 1. Are you able to move around or climb a flight of stair or two? 2. Does this pain allow you to type normally here? If your answer is no, you need to see the doctor on priority. If it isn't that painful and it allows you type here, can you elaborate your complaints further? Regards

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Brief Answer: Regular follow ups is the key... Detailed Answer: Hi, I wasn't aware you had posted more questions. I was able to gather some information from your previous posts. Apparently you been diagnosed with RSD and are unable to find effective treatment. If this pain wasn't an acute complaint, then it doesn't solve my purpose to send you to the ER. I initially related your complaints to acute coronary artery disease (CAD). However if it is only pain arising from the chest, I would definitely consider a heart check up before excluding it out from my list of differentials. If you haven't done that, you should discuss with your treating physician. Since you been diagnosed with RSD after extensive investigations, I hope and expect that all angles of heart are looked into. In such cases, regular follow up and being strict with your doctors' instructions is going to be the key. There are multiple drugs that are used to lower pain threshold. Carbamazepine and pregabalin are the most commonly used ones. Besides these nerve blocks at brachial plexus or intrathecal baclofen pumps are known to reduce pain significantly. This treatment can be monitored by neurologist and pain medicine doctors regularly who can titrate the dose and frequency of medicines. I recommend you consult both these specialist and follow up with them regularly. Hope this helps. Let me know if you need clarifications. Regards

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