patient presents to ED with complaint of epigastric pain.

Pain described as burning, gradual, and episodic.
Patient is not diaphoretic during pain. No radiation to arm. Denies exertional component.
Pt denies personal history of cardiac disease and family history of cardiac disease under the age of 50yo.
Reports no specific relationship with fatty meals. No recent binge drinking episodes. No history of alcohol abuse or smoking.
Patient denies SOB or productive cough.
Pt without dysuria or changes to urinary/bowel habits. Denies history of abdominal surgery.
Denies F/N/V.

Pt has never trial’ed antacid therapy or conservative GERD measures such as timing eating before lying flat or avoiding trigger foods.