Well, the good news is that you're still alive. The bad news is that it still hurts. I have no idea what you mean by "total work up" but I would certainly recommend talking w/your family physician for further evaluation. Not everything that hurts is related to the heart. However, an aortic dissection could cause chest pain. So could esophageal issues, eg esophagitis, strictures, spasms, tears, etc. Likewise, heartburn can cause chest pain. It's less likely to be due to mediastinal issues although that could also cause chest pain. Pneumothoraces could cause chest pain but you'd think that after 3 years, someone would have figured that out. Same for pneumonias. On the other hand, I suppose asthma could do this, although I would expect shortness of breath to be a larger issue. So go see your family physician.
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