Hi, thanks for posting your concern in the HCM. The symptoms may occur from a gastroesophageal reflux disease or laryngopharyngeal reflux or peptic ulcer disease or gastritis or gall bladder or liver pathology. An attack of acute coronary syndrome may also mimic them and in the later pain or discomfort often radiates to the arm. So, you should have an ECG done at the earliest. In case it is inconclusive a repeat ECG and spot test for Trop T may be done ( preferably 4hrs after the onset of symptoms). Blood examination for cardiac enzymes should be done. In case, a cardiac etiology is excluded you may start on a proton pump inhibitor (pantoprazole or omeprazole or rabeprazole) along with a prokinetic agent (e.g. domperidone). If the condition persists you will need to consult a gastroenterologist to rule out any gi pathology. Direct visualisation with endoscope may be needed along with routine investigations and ECG.For any further questions, please write back to us. Regards. Dr. Kaushik