The three commonest causes of chest pain are musculoskeletal, gastrointestinal and cardiac in origin. There are also many other occasional causes including problems with the lung, gallbladder, aorta (the main blood vessel), infections (e.g. shingles) and others.
People with chest pain should always consult a doctor for an assessment of a likely cause. Particularly in middle-aged or elderly patients, a cardiac origin for the chest pain is a possibility. If the chest pain (or arm, throat, neck, back) pain is provoked by exertion, then there is a reasonable chance that the heart is the source of the pain.
Patients with chest pain suggestive of a cardiac origin, or in whom the diagnosis is unknown should be reviewed by a cardiologist. A careful history of the pain is taken, the patient examined, an ECG taken and often an exercise treadmill test and an echocardiogram are arranged to assess the likelihood of the chest pain originating from the heart.