Hi, I am 27 yo male. I have been smoking for more than 10 years, i got few irritating symptoms since 4 years. Symptoms started with SOB and localized stabbing pain in my chest and upper stomach, numbness and pain in my left arm and shoulder, doctors said it could be cardiac issue since symptoms get worsen with smoking and after it and last like for 1-2 hours.anyhow, i did all the cardiac workup but i am free , so doctors thought this could be GERD ! so i started PPIs and antiacides which settle my symptoms for a while .The thing is , if i smoke more than 10 ciggs in a day , for few days, i will get this . Also it is triggered with coffee and lack of sleep !!what diagnosis might be in my case and how to handle it ?