Gastrointestinal System
A 43-year-old woman complains about an intermittent radiating pain in the left chest for 3 weeks. She also mentions a chronic cough. The pain is more prominent when lying down on her back compared to sitting. At night, she sleeps better with
multiple pillows. Symptoms occur shortly after eating spicy food. Examination reveals a white coating on the tongue. Body temperature is 37.2°C; blood pressure 118/83 mm Hg; heart rate 80 beats per minute; and respiratory rate 16 breaths per minute. Heart and lung sounds are normal. The following tests were ordered and all came back normal: electrocardiogram (ECG), exercise stress test, white blood cell (WBC) count, and creatine kinase MB1 (CK-MB1) serum levels. Which of the following conditions is the most likely initial working diagnosis?
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