I’m sorry you are going through this. Yes the spasms are incredibly painful and are often mistaken for a heart attack although they last for hours. Mine is not caused by reflux and my EGDs all come back clear with no GERD but that is rare. Most nutcracker is triggered by that. It is diagnosed usually with an EGD when they measure the pressure of the restriction. As for treatment, everyone responds a little differently. They treat any acid reflux and try dietary changes, medications such as nitroglycerin sometimes help. One surgeon told me his patients take mint oil or mint tea at the onset of an attack and it really helps. There is a surgery called a POEM surgery that can help. Also, some get Botox injections in their esophagus. It works but overtime can give scar tissue which causes other problems. Discuss the best option for you with your dr. I was diagnosed after a few attacks, I went into the ER and they thought it was a heart attack but wasn’t. Then tested for gallbladder, then spleen, then for pancreatitis. After all was ruled out a Dr tested for nutcracker. I hope you get some relief soon. Hang in there