With recurrent pain, history of acid reflux and in a 22 year female; it is not likely to be a heart disease. Still standard of protocol is get an EKG and chest x-ray.
Following should be the possibilities;
1) GERD with the history of reflux would be prime consideration as it is one of the commonest cause for non cardiac chest pain.
2) Hiatus hernia
4) Costochondritis; it is inflammation at the junctions of rib and cartilage or with the breast bone / sternum. Local analgesic ointment, or spray, chest brace and warm compresses with Ibuprofen is helpful. Another possibility is muscle sprain. Please read about the costochondritis;
5) Esophageal spasm
6) Myofascial pain syndrome
Investigations like Barium esophagogram, Esophagogastroduodenoscopy (EGD; camera exam), Esophageal manometry, Ambulatory 24-hour pH monitoring may be the next step of evaluation by your doctor. Anxiety and stress can increase any condition. Following meanwhile can help and should be tried (help in GERD and hiatal hernia):
1) antacids; Maalox
2) acid blocker; Prilosec
3) loosing weight, if overweight.
4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products
5) avoiding large meals. Eat 5 small meals in a day.
6) wait three hours after the meal before you sleep.
7) elevate head end of the bed by 8 inches.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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