<s>[INST] Hello sir,i am 30 years old male,having feeling tightness in the middle if the chest and sometimes upper left side of the chest which radiates to left hand and upper back as well.i have done xray and ecg everythiinng normal.i am worried what would be the problem? [/INST] Thanks for your question on Health Care Magic. I can understand your situation and problem. Possibility of stress related GERD (gastroesophageal reflux disease) is more in your case. Since your cardiac work up is normal, no need to worry for major cardiac diseases. Stress cause GERD. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause central chest pain, tightness, heaviness, burping etc. So avoid stress and tension, be relax and calm. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Start proton pump inhibitors and prokinetic drugs. Don't worry, you will mostly improve with all these treatment. Hope I have solved your query. Wish you good health. Thanks. </s>