People always have symptoms of precordial pain in their daily lives and sometimes worry if it is a heart attack. So is anterior heart pain angina pectoris? There are many causes of precordial pain, the most common being muscle soft tissue injury and esophageal acid reflux. The most common ones that lead to serious consequences are angina and myocardial infarction due to severe cardiac coronary artery sclerosis disease, ruptured thoracic aortic aneurysm and pulmonary hematochezia. Other causes of precordial pain can often occur, such as acute pericarditis, pleurisy, pneumonia, etc. The pain in the precordial region due to coronary artery disease is mostly associated with activity and exertion. The symptoms can be relieved quickly after rest. Sometimes it is accompanied by pain radiating to the neck and shoulders, shortness of breath, dizziness, and weakness. These symptoms should be taken seriously. In particular, patients older than 45 years old for men and 55 years old for women, with family history, smoking history, hypertension, hyperlipidemia, diabetes and other risk factors should be further investigated. Non-invasive and invasive tests are available, and depending on symptoms, risk factors and ECG and blood tests, the doctor will recommend a specific test. Non-invasive methods include exercise panels, exercise panels or drug-induced plus imaging methods such as exercise or drug cardiac ultrasound, exercise or drug nuclear medicine, drug-induced cardiac MRI, and CT coronary angiography. Each test has its advantages and disadvantages. Briefly, the sensitivity of a single exercise panel test is relatively low, 55-60%. The addition of imaging methods can significantly improve sensitivity and specificity. Nuclear medicine examinations are widely used, but have radiation exposure and should not be repeated too many times. Cardiac ultrasound is convenient and economical, without radiation exposure, but is less sensitive to small ischemia, and sometimes image quality is affected by soft tissue scarring, lung and obesity. Cardiac MRI provides the highest specificity and sensitivity without radiation exposure, but has higher technical requirements and is not available in every hospital. Cardiac CT angiography provides a clear coronary diagnosis, especially for normal coronary vessels. With a clear diagnosis, treatment is easier. The development of thoracic aortic aneurysm is a chronic process. Although diagnostic tools include cardiac MRI or cardiac CT, follow-up is needed to ensure that the aneurysm does not grow more than 0.5 cm per year or that the aneurysm is less than 5.5 cm, or less than 4.5-5 cm if the patient has congenital Bicuspid aortic office or Marfan’s syndrome. These are indications for surgical repair. Pulmonary artery thrombosis is also a common and high-risk acute condition. It is usually an acute condition due to the dislodgement of a lower extremity thrombus into the lung. It is common in people with lower extremity surgery, prolonged bed rest, tumors and abnormal blood coagulation. Chest CT or nuclear medicine with blood tests and ultrasound of the lower extremities often provide an easy diagnosis. Anticoagulation therapy should be started as soon as possible. Other precordial pain is rarely life-threatening. The vast majority of precordial pain is nonspecific, such as soft tissue injury and esophageal reflux, and can be investigated and treated accordingly.