I had a terrible episode last night. I've grown almost use to the 7,000+ PAC's and PVC's, but yesterday (out of the blue) My blood pressure got very elevated for me 148/80 (normal 100/700). I developed tachycardia,shortness of breath,irregular heartbeats and chest pain. During the episode, I had a hard (teeth chattering)chill that lasted for about 15 minutes - after the chill, my nose, fingers and toes burned like I had been out in the snow...except there is no snow, it's 90 degrees here. I took lopressor 25 mg and an Ativaan .50 mg and it finally slowed down about an hour later. Then I was exhausted for the rest of the day and still fill quite fatigued today. I take Toprol XL 25mg one in the morning and evening, as well as, Pravachol 40 mg, Zetia for (elev cholesterol). I never now when I should go to the ER. I have a 40% block in in LAD, 80% block D1 and moderate left ventricular hypertrophy. I understand the arrhythmia, can anyone explain the chills and burning symptoms. Thanks to all for this wonderful forum.