There are many patients with chest pain, chest tightness or premature beats who have been treated for coronary artery disease, and we have met many patients who have had coronary stents placed or even had coronary artery bypass grafting done without improvement, but the last investigation was gastroesophageal reflux disease. Gastroesophageal reflux causes chest pain is not uncommon, but doctors just do not pay attention to it. The two are easily confused for the following reasons: 1. similar pain sites: the heart and esophagus are innervated by a single nerve, and the nociceptive fibers of both sometimes cross over and manifest as pain in the same area. 2. In gastroesophageal reflux, gastric acid can stimulate the esophageal vagus nerve and cause spasmodic contraction of the coronary arteries through neurological reflexes, resulting in ST-T changes or arrhythmias. 3.Similar triggering factors: both can have an attack during a full meal, sleep, or emotional excitement. 4, similar response to nitroglycerin: nitroglycerin can relax esophageal smooth muscle and alleviate the symptoms of GERD chest pain by relieving esophageal spasm, making patients more convinced that they are coronary artery disease. 5, gastroesophageal reflux is an important trigger for some angina attacks in coronary artery disease, and sometimes the two are simply indistinguishable. So I remind such patients of chest pain, chest tightness and premature beats don’t keep focusing on the heart.