I really am not sure but sounds very similar. I have the vagus nerve issue too. My HH is mild so doc thinks it is GERD related instead with spasms causing the tightening. There was a reply on here before, but now I don't see it where a woman said her husband had what we are experiencing, and doctor had him take OTC FD Gard. It is to help with indigestion type issues and he also put him on an anti anxiety med to help with the tightening. I also get pain higher up now going up into shoulder. It's like it has taken over the entire ribcage front and back. I also get pain in upper epigastric region and runs along under ribcage. HH can cause this pain but usually people say they feel like food gets stuck with it. Do you get that symptom? I am at the point that I just want something to stop the symptoms. Vagus nerve, spasms etc. might respond to Elavil. It's an older antidepressant used for nerve pain. Also you might want to see if a muscle relaxer helps or the hyoscamine I mentioned. Problem is that our symptoms could be caused by GERD, HH, gastritis, pancreatitis etc. So hard to figure out what it is. Have you had endoscopy and other tests to rule out other issues? Sorry for rambling!