My 16 year old daughter is complaining of chest pain around diaphragm and sternal area, she has a heart rate of 100, B/P is 130/78 and skin is blotchy and cold to the touch. She does not feel anxious.Blanching of the nail beds seem to be normal and are pink in color. She has dx s of Crohn s, JRA, Chronic Histoplasmosis (last lab normal), Atrial Septal Defect, Anemia, low Ca. Should I be concerned about the symptoms of the vital signs she exhibiting?