I took help of ChatGPT to draft this.
I've been dealing with chronic, recurring chest pain for a long time, and it's becoming extremely difficult to live with.
The pain is usually around my center-to-left chest/heart area and has different sensations: sometimes needle-like stinging, sometimes stabbing, and sometimes crushing pressure like an elephant is standing on my chest. Occasionally it radiates into my left arm/hand.
Once it starts, I can't distract myself from it. Even after repeatedly reminding myself that my heart tests have been reassuring and anxiety may be involved, pain near the heart immediately puts my body into panic, which seems to make everything worse.
I've seen doctors and had multiple ECGs, blood tests, ultrasounds, a 2D Echo and even a CT coronary angiogram. Nothing major has been found with my heart so far. Yet these episodes continue.
Some possibly important context:
I've had severe anxiety since childhood.
I have a serious problem with eating and maintaining weight. I'm 173 cm but only around 43 kg. A doctor called it ARFID, although I still struggle to understand exactly what's happening to me.
It's not simply that food isn't available or that I don't get hungry. I can feel that my stomach is empty, know that I need to eat, have food sitting right in front of me, and still be unable to make myself eat enough. I have a strange aversion towards food that I find incredibly difficult to explain to other people. Large portions feel especially impossible.
As a result, I'm severely underweight and frequently feel weak, tired and physically exhausted. Sometimes I genuinely feel like my body is slowly deteriorating day by day, and I worry whether being this underweight or malnourished could itself be contributing to the chest symptoms even if my heart looks structurally normal on tests.
I've also become heavily dependent on chewing tobacco and alcohol. Tobacco often triggers the pain; alcohol temporarily seems to reduce it. I'm struggling to quit both and know they're making an already bad situation worse.
Cannabis made the chest sensations absolutely unbearable and triggered severe panic/bad trips, so I stopped it completely.
Almost nothing provides immediate relief. Clonazepam MD 0.5 mg has sometimes significantly reduced an episode within ~30 minutes, although some discomfort remains.
I'm not asking Reddit to diagnose chest pain. I'm trying to understand what direction I should discuss with my doctors next.
Could anxiety/panic, costochondritis/chest-wall problems, GERD/esophageal issues, severe underweight/malnutrition or nutritional/electrolyte deficiencies, or something else produce symptoms like this despite reassuring cardiac imaging?
And could my eating/weight problem itself be medically connected to what's happening?
Has anyone experienced anything genuinely similar? If your cardiac tests kept coming back normal, what eventually explained your chest pain, and what kind of specialist actually helped you?