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I feel chest pressure - what could it be?

dear dr. i have chest pressure all day some time when i do activity or when resting some time its tightness feeling and it radiate to my back. i did the follwing test: ECG, ECHO, stress test, cardiac anzyma, chest x-ray, cardiac CT angiography 256 SLICE, lung function test, brain MRI, brain EEG, full blood count, thyroid blood test. all come back normal. and last year i had some gastric problems so i did endoscopy and abdominal ct scan they found 2cm hernia and lax cardia. please help me and i have palptation and tachycardia when standing some time even when sitting whats wrong whith me please? 32 years old male, smoker 2 pack day, 105 lbs, 5.5" ,
Whenever someone has a sensation of chest pressure, the first thing that needs to be ruled out is a heart attack or other serious heart condition. If you have sudden, new severe chest pressure or pain that does not go away, then you should always immediately go to an emergency room for evaluation. That being said, it does sound like you've had a fairly extensive heart workup, although it is not clear from your question when exactly this was done. This workup, if recent, does make it less likely that you have a serious heart condition. However, the palpitations that you are having are still concerning, and that might require additional workup. I recommend that you discuss this with your primary care doctor. All in all, the other thing in your question that stands out is your smoking history. This is the most concerning thing, as smoking causes and exacerbates heart disease, causes palpitations, and may also cause gastric problems. So it is possible that all of your symptoms are related to this and may drastically improve if you quit smoking. I would recommend going to see your primary care doctor as soon as possible. They will be able to help you synthesize the data from all these tests that you have had done, advise you about quitting smoking, and help you figure out if additional tests are needed.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.

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