Brief Answer:
different possible causes

Detailed Answer:
Hi, thanks for using Ask A Doctor service...

The area right below the chest, just above the abdomen would be the epigastrium.

There are a number of different causes for epigastric pain. Accurate diagnosis is dependent on both history and examination.

A history of the nature of the pain (eg description -stabbing, colicky etc), affected/worsened by any particular body position, worse/affected at a particular point of the day, associated symptoms- eg nausea, change in bowel habits, loss of appetite etc

The doctors would have elicited this history and examined your abdomen and chest looking for any tenderness, hernias and any other obvious signs.

Possible causes of epigastric pain include:(1) GERD- you stated however that it did not feel as though it was GERD

(2)pain related to the gallbladder- in many persons, however, may be worse after use of fatty or fried foods but not in all cases

(3)gastritis- inflammation or injury to the lining of the stomach

(4)a pancreatic disease can also cause epigastric discomfort in some persons

(5)irritable bowel syndrome can present with epigastric or other abdominal pain but it must continue for at least 6 months before a diagnosis is made

(6)a hiatal hernia- this does not usually cause symptoms in most persons but it can however sometimes cause chest or epigastric pain

(7)Referred pain- In medicine, persons may also experience referred pain. This means that the pain is due to a problem in one area that was sent or referred to another eg persons with a toothache experience pain in the ear
It has to do with the origin of the nerves in a particular area.

In terms of the epigastrium-pain can be referred from the pleura (lining of the lung) or the heart (this is the reason they would have needed to assess the heart in the ER) or the spinal nerves (nerves running through the spinal cord)

(8)esophageal spasms- contraction or spasm of the esophagus can cause this type of pain to occur

If the pain recurs then you may want to consider visiting your family doctor for assessment and examination. Imaging such as abdominal ultrasound and repeat endoscopy may be needed.
Additional tests may also be done depending on the findings.

I hope this helps, feel free to ask any other questions

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Brief Answer:
rules out some of the conditions

Detailed Answer:
HI

A stabbing intermittent pain, not affected by movement/activity and with no additional symptoms- may be more in keeping with a nerve related cause (spinal nerves) or hiatal hernia or esophageal spasms.

In the other conditions there are usually additional symptoms that may be present such as change in bowel movements, fever, weight loss etc

If it recurs, imaging would still be really helpful in finding the exact cause.

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