To differentiate chest pain caused by heart disease from GERD, a doctor will take an anamnesis to ask about the history of the disease and perform a physical examination.

To make a diagnosis of heart disease, examinations need to be carried out, including:

1. An electrocardiogram (EKG) is a recording of the heart's electrical activity. This examination can assess the presence of ischemia (obstruction of blood flow to the heart muscle) due to coronary artery disease.

2. An echocardiogram is a heart examination using ultrasound.

3. Exercise Stress Test (Treadmill Test) is a heart examination by installing a heart monitor and recording while walking or running on a treadmill machine.

4. Troponin I is a blood test to see damage to the heart muscle.

5. CT Cardiac is a CT scan of the heart which can detect abnormalities in the structure of the heart such as blocked coronary arteries, blood vessel anomalies and other abnormalities so that it can detect abnormalities early and make a correct diagnosis.

For someone who often complains of chest pain and non-invasive examinations such as ECG, treadmill, CT cardiac show signs of ischemia, the doctor will recommend cardiac catheterization. Cardiac catheterization is a medical procedure that involves inserting a device such as a thin, long and elastic tube into the blood vessels of the heart so that it can determine the cause of chest pain and immediately determine the next action or treatment.

To confirm the diagnosis of GERD, it is necessary to carry out examinations including:
1. The PPI therapy test is the administration of a double dose of PPI for 1-2 weeks before endoscopy. If symptoms improve during therapy and worsen when therapy is stopped, then the diagnosis can be made.

2. Endoscopy is an examination of internal organs using a small tube with a camera.

3. Oesophageal pH monitoring is an examination using a tube that is inserted through the nose into the abdominal cavity (oesophagus). This examination measures the acidity level in the esophagus.

Author: dr. Dian Rahma Dewi (Medical Services Doctor Surabaya Adityawarman Branch)