I have been experiencing dizziness and extreme fatigue once a week. Today I am tired and have had throbbing chest pain on the right side for about 20 minutes. I have palpitations, and my heart rate is 73 beats per minute. I take tablet Fluoxetine and tablet Ritalin. I have tingling sensations on my foot. I was diagnosed with poor circulation and tennis elbow. I am a smoker. Should I go to the emergency room?