<human>: i am having an intermittent chest pain in the center of my chest. that hurts more when i lay down or breathe deeply. it started before i went to sleep but i ignored it and fell asleep but i woke up sweating a lot and my nose began to bleed. what it causing this and how can i fix it?
<bot>: Hello! Thank you for asking on Chat Doctor! I read your question carefully and understand your concern. Did you measure your blood pressure during this episode? Nose bleeding is commonly caused by uncontrolled high blood pressure. A wide differential diagnosis between different disorders affecting the mediastinal structures should be done:- A Costco Chat Doctor.  But would not explain the bleeding nose. The pain modulated by body position or respiratory movements is usually musculoskeletal. - an aorta dissection, but this would not explain the pain modulation with respiratory movements. - your symptoms don't seem to be cardiac related, as it is very atypical for the cardiac pain to be modulated from respiratory movements. I recommend consulting with the GP for a careful physical examination and performing some tests like : a chest x-ray, resting ECG, routine blood test, kidney and liver function tests, blood electrolytes, thyroid hormone levels, to establish the possible cause. Meanwhile, I advise to closely monitor your blood pressure. Hope to have been of help! Best wishes, 