Persistent retrosternal chest pressure + dull jaw discomfort

34M, moderate smoker.

Since Nov 2025, after taking metoclopramide + fluoxetine, I had what felt like a panic-like episode. Shortly after that, I started developing symptoms that have not fully resolved.

Main symptoms:
Persistent or recurrent retrosternal squeezing/pressure-like chest pain
Occasional electric shock-like sensation in the left chest
Dull discomfort in the jaw/teeth area (no dental cause found)
Jaw sometimes feels mildly tender when touched
Symptoms occur both at rest and during exertion
Chronic symptoms without full remission
No shortness of breath, nausea, dizziness, or sweating

The chest sensation feels more like angina-type discomfort than a typical panic attack.

Mental health / medication background:

After the initial episode in November 2025, I switched from fluoxetine to escitalopram, and also used a short course of benzodiazepines because fluoxetine was suspected to be too activating.

Following this change, I felt noticeably better for about 1–2 weeks.

However, in December 2025, I suddenly developed a stronger episode of retrosternal squeezing chest pain, which triggered significant fear and panic. Since then, the chest pressure has persisted as part of the ongoing symptoms.

I am also currently being treated for panic/anxiety disorder with escitalopram.

Even with my history of anxiety, I have never experienced symptoms like this before, which is why I’m confused about the cause.

Cardiac workup:
Resting ECG: normal
Echocardiogram: normal
Exercise stress test: achieved 12.4 METs, interpreted by the cardiologist as clinically and electrically normal, with no ischemia and no symptom reproduction
Blood tests including troponin: normal

➡️ Overall, cardiac causes were considered very unlikely.

Gastroenterology workup (endoscopy):
Grade 1 sliding hiatal hernia
Distal esophageal erythema / reflux esophagitis
Mild chronic gastritis
H. pylori infection (currently under eradication treatment)
Current issue:

Despite treatment, I still experience persistent retrosternal chest pressure and dull jaw discomfort, and I’m struggling to understand what is causing it.

Possible explanations I’ve considered:
GERD / reflux-related non-cardiac chest pain
Hiatal hernia–related discomfort
Esophageal hypersensitivity or spasm
Musculoskeletal chest wall pain
Referred or nerve-related pain affecting the jaw area
Anxiety/stress amplifying physical symptoms
Main question:

What could explain this combination of:

retrosternal squeezing chest pressure
dull jaw discomfort
normal cardiac workup (including stress test and troponin)
mild but real GI findings
absence of classic cardiac-associated symptoms
and symptoms that feel very different from my usual panic/anxiety episodes?

Has anyone experienced something similar or found an explanation for this kind of symptom pattern?