hi
Coronary angiogram is the gold standard test for diagnosis of coronary artery disease with a sensitivity level as high as 99.9% .
so the chest pain and burning sensation is not because of cardiac cause.
There are some other causes which can present with the same symptoms and can mimic pain of cardiac origin
few of them are
gastritis
heart burn
acid peptic disorder
As you say ,you have acid reflux for several years ,you were diagnose with
duodenal ulcer ,ATT therapy also increases formation of acid and causes severe gastritis,most likely cause of your chest heaviness and pain is GERD( gastro oesophageal reflux disease).
Gastroesophageal reflux disease (GERD), Also known as acid reflux.
GERD occurs when stomach contents move back into the throat. This may cause a burning sensation in the chest known as heartburn.
Once cardiac condition has been excluded , the most common cause of chest pain is GERD.
I would like to say that treatment of GERD is done according to the following guidelines
Patients are often prescribed a proton pump inhibitor (PPI) also called a PPI trial(eg omeprazole). They must be taken at least 30-60 minutes before breakfast.If the patient responds, the treatment can be continued for at least 8 weeks.
For patients not responding to a PPI(as in your case) alone a combination of PPI with
Levosulpiride should be tried for 4 weeks.
Low doses from the class of drugs known as tricyclic antidepressants (TCAs) are used in patients not responding to PPI'S and levosulpiride cobination.These medications are felt to produce their favorable effect by reducing pain transmission from the esophagus to the brain. The two most commonly used agents are imipramine and trazodone.
For patients not responding to either acid inhibition trial or TCA , esophageal motility testing (a study done to evaluate the muscle contractions of the swallowing pipe) may be done to look for other uncommon causes of chest pain such as achalasia. Esophageal achalasia is an
esophageal motility disorder involving the
smooth muscle layer of the esophagus and the lower esophageal sphincter (LES), Achalasia is characterized by difficulty in swallowing, regurgitation, and sometimes
severe chest pain and burning sensation.
A
peptic ulcer are one of the most important cause of dizziness,chest heaviness and explains all your symptoms.
its not your heart its because of gastritis and ATT increases it