42y/o m. i have chronic chest pains, had all possible cardiac tests, all negative. mri -, what could it be.r/o gastro prob and costacondritis. 10yr

Chronic Chest Pain: Chest pain with negative cardiac eval is virtually always due to gastroesophageal disease / spasm or costochondral ( musculoskeletal) sources. The source of the pain is not always as important as finding something which gives you good relief and improves your quality of life. It is also posible that this is pleuritic in nature, but i think someone might have picked up on this already.

Any other symptoms?: I am assuming you are not asthmatic. I see you know a good deal of the differential diagnosis. There is a subset of patients with negative gastroduodenoscopy (egd) that may have esophageal spasm. A specialized study that measure pressures at the esophagus can be diagnostic. Also anxiety disorders/psychosomatic should be in the differential. Connective tissue diseases/ myopathy also possibilities.