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has he had anxiety attacks before?
it would be very unusual for him to have a heart attack at age 38
if he has had anxiety and panic attacks before, then most likely anxiety or panic attack symptoms are causing his racing heart and muscle cramps
blood clots would cause swelling in the arm and would be very unlikely at his age.
he may be dehydrated or low in potassium which can cause muscle cramps in the arm.
make sure he drinks more fluid and orange juice to get potassium in his system and use warm heat to his arm
and if he has anxiety medications like xanax or ativan, he can take them.
the caffeine doesn't help either and most likely is dehydrating him and causing his fast heart rate.