About two and a half years ago, my blood pressure was really high but I had no chest pain. It was determined that I had a really slow heartbeat and that a pacemaker was needed. Almost immediately after the installation, I started having pretty severe chest pains that sometimes went to the left arm and the lower jaw. Sometimes to the right arm also. Nitro pills under the tongue worked the best for eleviating the pain. After a number of tests and a heart cath, no determination was made as to why I had these attacks. On a good day I may take 3 nitro pills a day. On a bad day, maybe 9. Also, certain foods such as sugar or onions will trigger attacks. Tests for Gerd didn t show anything either. As I said, I had no pains until after this pacemaker was installed.