19 Sep 46-year-old male complains of chest pain described
46-year-old male complains of chest pain described as pain in his midchest for the past couple of months that has progressively worsened over the last couple of weeks. He states it has worsened when he is going to bed at night or when he eats a large meal. He has been eating out a lot more over the past couple of months because he has been traveling a lot for work. He denies any nausea or vomiting. He has been taking OTC Tums for the past few weeks, but he has to take 10-12 a day and only gets minimal relief. He denies any unusual weight gain or loss. Physical exam reveals an obese, Caucasian male with mild epigastric tenderness. No hepatosplenomegaly. Bowel sounds normoactive in all four quadrants. Provide the most likely diagnosis based on the HPI and PE. In addition, provide your interpretation of the cues found in the assessment. List at least 3 possible differential diagnoses and justify your rationale. Develop therapeutic plan options based on quality, evidence-based clinical guidelines.
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