Chest pain in a 19 year old male

Dear Ask The Doctor: I'm 19 years old i'm a male. I have a history of high blood pressure in my family on my moms side but have yet to expierience it myself as far as I know. I've had multiple EKGs and an echo cardio gram. As well as tests for checicals releassed during a heart attack all were normal. But I have a very sharp chest pain the I get in the left side of my chest and also in my sternum it takes my breathe away. And it only happens when i'm at rest. I've been treated for GI problems which did nothing at all. I'm very worried i'm going to die suddenly as I get confused and dizzy when the pain comes. It usually last about 5-25 minutes then goes away. I smoke, drink coffee, and used to do cocaine on a regular basis but have since stopped using it. I dont smoke that much but that pain does happen when I smoke or drink coffee. I'm very worried please help any suggestions or recommendations would be greatly apprecaited thank you so much. I've been diagnosed with palpitations but this seems very unrelated I never experienced pain with the palpitations and they only came when I was using cocaine. Scott H Brown

Dear Scott: The chest pain seems to be an angina pain. Angina pectoris is a condition of chest discomfort that occurs when there is a decreased blood oxygen supply to an area of the heart muscle, usually due to narrowing of the coronary arteries as a result of arteriosclerosis or coronary artery spasm. Sometimes there may not be any positive findings on the EKG or cardiac enzymes to help diagnose the condition. Stress test is the test of choice for the diagnosis of the condition. You need to avoid the triggers like coffee, smoke to prevent angina episodes. Your doctor may prescribe medications like nitroglycerine, beta blockers, calcium channel blockers etc. to treat the acute episode as well as prevent future attacks. Hope this helps.