### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
why do i feel a pain in my chest and exactly the same point on my back as if i were punced/hurtt there? i have shown cardiologist, he says no heart prob my cholestrol levels ok, but am overweight obese/ but pain persists, just in the centre of my breast.

### output:

Hello! Welcome and thank you for asking on Chat Doctor! Regarding your concern, I would explain that a comprehensive differential diagnosis of many disorders affecting the mediastinal structures (bones, esophagus, lungs, musculoskeletal, aorta, etc.) should be done. I agree with your doctor on the fact that your symptoms don't seem to be cardiac related. A prolonged chest pain is not characteristic for any cardiac disorders. From the other hand, I would like to know if your symptoms are modulated by respiration or body movements. This pattern would go in favor of a muscle skeletal disorder. A backbone disorder (like chronic degenerative changes of the vertebral column), could mimic this clinical scenario. Are your symptoms related to eating? A gastroesophageal reflux or esophagitis could cause similar symptoms with heartburn and burping. I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x-ray and some blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, blood electrolytes, etc.). A fibrogastroscopy for possible esophagitis or gastritis and a cervico-thoracal x-ray study may be needed to exclude the above-mentioned disorders. If all the above-mentioned tests result normal, I would recommend taking some painkillers (ibuprofen, acetaminophen), which would help in case of a musculoskeletal pain. I would also advise performing a lot of physical activity and lose weight. Hope to have been of help! Best wishes, 