Question: Hello I a, a 64 year old white male with symptoms as follows : sharp non radiating pain that comes without a known stimulus , like exercise, eating spicy food , etc . The pain is mid epigastrium and radiates toward the right scapula. I am status post pacemaker insertion for so called sick sinus syndrome secondary to idiopathic cardiomyopathy. This pain does not seem to be cardiac in nature . I underwent CT with contrast of abdomen and ultrasound and Nuc Med to rule out gallbladder , the studies were normal.
the pain is elusive and not I am not able to say how often it occurs but pushed I would say rare , however when does present it is quite painful greater than 7 if 10 is awful, it is fairly short in duration but doesn't seem to respond to acid pump inhibitors , h2 blockers, or chalk like acid reducers .. a physical exam would be fairly normal , 5'7 137 lbs . Heart and lung sounds normal , slight grade 1/2 soft systolic murmur . ETT was normal. Abdomen soft and non tender , splenomegaly or hepatomegaly < blood chem is unremarkable , Lipid is triglyceride 90, Total Cholesterol 160 , LDL 70 and HDL 58 particle LDL using NMR method is B profile is moderate risk 8% for 5 year. Do you think it could be esophageal , about 10 years ago I had egd for similar and reflux and Hiatal Hernia were discovered ... I did have pancreatitis 25 years ago required short hospital stay of 5 days . thanks

Thank you sir , I thought GERDs too , and will try another proton pump inhibitor > I am fairly concerned about a pancreatic disorder and I have it looked into, I have a non functioning DDDR pacemaker , so I don't know if I can have MRI safely >
Thank you again