unexplained acute chest pain

I have had acute stabbing pain in my back, chest high, radiating up in to my jaw developing into pressure and nausea. A few years ago I had a work up for the heart. It was negative.  I have had a long history of GERD.  It was solved with a Nissen Fundiplication in 12/05. I thought this would cure the problem but it didn't.  My GERD is gone and I no longer need medicine for it but these attacks keep coming back.  My doctors are stumped. It is not triggered by food or stress.  I could have 2 in a day or go a few months without one.  The pain comes un suddenly anf is extremely penetrating .  The funny thing is that if I take a Nexium, the pain will go away within 1 min.  If I don't take the nexium, the pain will not stop and will increase to include chest pressure with pain and nausea radiating into the jaws and face.  I wish someone could diagnose this problem.  I know Nexium can not work that fast but it does.  MY doctor thinks it is a spasm but it certainly is severe.  I am tired of carrying water around waiting for the next attack.  Please help!  Thank you.

[Ratnakar Kini, MD]

Hi,
24 hours pH monitoring test and esophageal manometry would be helpful in diagnosis.
24 hours pH monitoring test  would be able to find if there is any reflux and esophageal monitoring test would be able to find if there are any spasms.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.