Chest pain for1 week-tightness in chest was periodic and now constant. had echo stress-test, no blockage. have lupus, now chills, no fever, now what?

Many causes: Could still have coronary artery disease depending on the pattern although not typical. You describe a now constant pain with a normal stress test in patient with lupus- would definitely consider pericarditis (not unusual in lupus). Also can consider noncardiac etiologies- musculoskeletal cauuses such as costochondritis, or GI causes such as esophagitis, gastritis, peptic ulcer, etc.