43 y old m with chest pain radiates to back shoulder blade and ribs cardio work up normal no gb/stones liver normal mgram brest normal

Continue work up. Check pancreatic enzymes-amylase, trial of antacids as reflux commonly gives this referral pattern. Any intra-abdominal pressure n the diaphragm may refer to the shoulder. Find an osteopathic physician who specializes in nmm -neuromusculoskeletal medicine for a structural evaluation, it may be a thoracic or cervical disc ...Usually c5-6.
See below. Many things can cause these symptoms. You need to see your doctor. He/she whill perform a thorough examination to see what's going on and tell you what to do about it.

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