hello, extreme heart burn in 21 year old male is mostly due to increase acid secretion in stomach, but we have seen young person complaining of this type of pain comes out to be heart origin. But before reached to any conclusion what want to know.. what is the exact location of pain what make it worse or better does it is related to exertion or food does this is associated to nausea or vomiting

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Brief Answer: Try antacid.... Detailed Answer: Hi, The pain seems to be due to GERD (heart burn). It should come down with antacid like tums. I would start proton pump inhibitor such as prilosec OTC once a day for a week as the treatment, before deciding to evaluate further. You can try tums and if needed prilosec OTC. If the pain remains same or if you start to sweat profusely and become breathless, you can proceed to the nearest ER. Hope this helps. Feel free to ask for clarifications. Regards

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Brief Answer: Physical examination and if needed one EKG... Detailed Answer: Hi, If you are still in pain at the ER, I would perform the following set of actions: 1. Physical examine specially the chest and abdominal areas including (chest ausculation) would be the first action. 2. EKG and some blood test would follow if there is any suspicion of serious concern. 3. I would inject you with medicines to control acid secretions of the stomach. 4. You may be asked to wait at the ER where they would monitor you for couple of hours until you are asymptomatic before sending you home. In brief, based on your description I assume you will most likely be at home with a prescription from the ER doctors unless the pain doesn't respond well to injections. Therefore my suggestions to try tums and prilosec at home. Hope this helps. Let me know if you know if you need any other information. Regards

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