Chest pain is a non-specific symptom and it covers any kind of chest discomfort.
Chest pain can be caused by different medical conditions include:
Cardiovascular, pleural, pulmonary, musculoskeletal, and gastrointestinal disorders.
Most frequent and life-threatening cause of chest pain is acute coronary syndrome and heart attack.
Acute coronary syndrome accounts around 30 % of chest pain.
Myocardial ischemia is usually described as dull, pressure, tightness, squeezing aching sensation, rather than sharp or spasmodic.
Sharp pain in a seconds is not common for myocardial ischemia.
Ischemis symptoms usually subside within 15-20 minutes, but it can last longer also.
Longer chest pain indicate myocardial infarction.
Progressive symptoms, or symptoms at rest can indicate unstable angina.
Myocardial ischemia is also associated with fear and anxiety, less commonly, shortness of breath, feeling of impending doom and sweating.
Location of the pain is retrosternal region, maybe slightly left sided. But patient can not indicate exact location of the pain.
Pain commonly irradiated to throat, lower, jaw, shoulders, inner arms more commonly left arm, upper abdomen, or back.
Ischemia pain is precipitated and exacerbated by physical activity, cold temperature and stress mand usually relieved by rest.
Unless diagnosis is confirmed first initial diagnostic test is ECG for all patients with chest pain, to exclude acute coronary syndrome.
Acute coronary syndrome is very common in Generally healthy individuals under 30 years of age.

If pain arises or worsens with palpation it is not ischemic pain, and high probability musculoskeletal pain.
such pain accounts around another 28 % of cases.
musculoskeletal pain may result from overuse or an injury to the chest area from trauma. Viruses can also cause pain in the chest area.
Muscle strain. Even really hard coughing can injure or inflame the muscles and tendons between the ribs and cause chest pain. The pain tends to persist and it worsens with activity.

Other common causes of chest discomfort include gastroesophageal reflux disease in 30% of cases.
Gastroesophageal reflux disease arises when, when stomach contents move back into the throat. This may cause a sour taste in the mouth and a burning sensation in the chest or throat, known as heartburn. Risk factors and triggers for Gastroesophageal disease include: obesity, smoking, pregnancy, and spicy or fatty foods. Pain nature is burning sensation and more constant.

Pericarditis. This is an inflammation or infection of the sac around the heart. It accounts 4 % of chest pain.
If chest pain is caused by pericarditis it may get worse when supine then upright, and increases with breathing, coughing or swallowing.
often causes a sharp, steady pain along the upper neck and shoulder muscle.
During auscultation, A cardiac friction rub represents pericarditis until proven otherwise.
is the cause of chest pain in 2 % of cases.
The absence of abnormal physical examination findings can be indicate pulmonary embolism.
Venus Thromboembolism the main cause of pulmonary embolism, and it is associatied with: trauma, recent surgery, prolonged immobilization, pregnancy.

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