44 fem anxty/panic hiatal hernia center chest pain in betw breast reflux burping EKG chest X-ray labs all good. 40mg Prilosec worried about cause?

The hiatal hernia. This type of hernia causes the reflux. If you're happy with your symptom control on the prilosec, it's ok to continue, but that drug causes oseoporosis, pneumonia, and gastric polyps. As young as you are, i recommend you consider having the hiatal hernia repaired by a surgeon, which ends your reflux for good. Also, if you have "asthma", this may be the reflux and an operation can cure that too.
Many reasons . Large hiatal hernias referred to as paraesophageal hernias can cause this type of pain. Esophageal spasm could also be a cause. An upper GI contrast study, esophageal manometry, 48 hour ph study, and upper endoscopy should be able to sort out any anatomic imitate physiologic issues if the esophagus and stomach that may be causing your pain.