Conversation: The conversation between human and AI assistant.
[|Human|] I have pain in the back , shoulders and arms which began when I rose from my armchair to go to bed. No shortness of breath but my personal blood pressure machine shows blood pressure of 158/98 and pulse rate of 96. I always have a fairly high pulse rate - at least 80.
[|AI|]  Hello! Welcome and thank you for asking on Chat Doctor! I understand your concern and would explain that a comprehensive differential diagnosis should be done to differentiate between different causes of this clinical scenario: - a backbone disorder. It could lead to pain in the back and shoulders, and high blood pressure due to the physical stress. - an aortic dissection could lead to this clinical scenario-anxiety could also cause similar symptoms. I recommend going to the ER for a careful physical exam and some tests: - a resting ECG and cardiac ultrasound- a chest X-ray study - a cervic-thoracic column X-ray study-some blood lab tests (CPK for possible myalgic, a complete blood count, inflammation tests). You should discuss with your doctor on the above issues. Hope you will find this answer helpful! Kind regards,