Yes good evening, I am 32 male smoker nondrinker, I am hqbing sharp pains in my upper left chest area, feels like my heart beats are staining my arteries, sometimes today my shoulder neck and upper left back cramp burn and pulsate with this pain as well. Should I go to the ER? Or is it anxiety , my wife and I have been having problems lately and I have been very stressed out lack of sleep not eating as much etc. Thank you kindly, please Dr. I have no money please email me what is wrong, I have 3 kids and I have to work tomorrow, please help