How can you tell the difference between anxiety chest pains and heart problems for a heavy drinker?

Formal Evaluation: The problem is that heavy alcohol use may result in many real problems that may be manifested in many ways, some of which may be ostensibly cardiovascular (including chest pain). Anxiety can be seen in heavy drinkers for a variety of reasons as well. Since one cannot reliably determine is any symptoms are psychological versus physical, a formal cardiac evaluation would be prudent.