I Have A Small Hole In My Heart And Chest Pain At Night While I Lay Down , Please Give Me The Suggestion For Treatemnet

chest pain at night while i lay down and try to sleep ok well first off im a 24 year old male and when i was 18 i had went to a heart doctor and had a stress test done and a ultrasound done to find out i have a small hole in my heart. well after 18 i had lost my health insurance and never go t back to the doctor. Well for a few months now i have had a shape pain thats comes in spikes in the left side of my chest when ever i lay down for bed. I took my blood pressure and it said 148 over 95, pulse 65 and i know thats kinda high for my age. Im not over weight infact im under weight. now this worries me, I do smoke about a pack a day and drink once a week. I really cant afford health insurance and it is not offered where i work. Also when i get this pain i have like a uncomfortable feeling some times and i get like a hot flash and sometimes heartburn. I know this is not normal and i need to get checked out but like i said really cant afford it.