Chest pain is a common clinical problem with several possible causes. Not all chest pain is due to a heart problem. The history and physical examination often provide useful information for making the diagnosis.

CAUSES

Originating from the heart:

• Ischaemic heart disease (angina pectoris, myocardial infarction)
• Acute pericarditis

Originating from the lungs and pleura:

• Pneumonia with pleurisy
• Pleural effusion or empyema
• Pulmonary embolism or pulmonary infarction
• Pneumothorax
• Tumour (lung cancer)

Originating from the oesophagus:

• Reflux oesophagitis
• Hiatus hernia
• Tumours

Originating from the aorta:

• Aortic dissection

Originating from the chest wall

• Intercostal myalgia
• Costochondritis