Chest pain is a very common symptom in cardiology clinics, and with the aging of the population and changes in the disease spectrum, there is an increasing trend of patients with chest pain as the main manifestation. Sudden onset of chest pain in daily life, people first think of heart problems. In fact, there are many causes of chest pain, including cardiac, respiratory, digestive, skeletal and muscular, but chest pain caused by coronary artery disease and aortic coarctation is a high-risk chest pain, and delayed diagnosis and treatment can be life-threatening. So, how to self-identify high-risk chest pain, neither overstressing nor seeking timely medical treatment? Chest pain caused by cardiovascular system Pain site: The main pain site of typical angina is behind the sternum, which can radiate to the precordial area and the left upper limb, so many people describe the pain site as pain in a hand-sized area in the precordial area. However, some people present with sore throat, left or both shoulders, neck pain, and upper and mid-abdominal pain. In non-anginal patients, the presentation is variable, and the pain may appear in a pinpoint area on the left side of the precordial region, sometimes left and sometimes right, and the location is often not fixed. The nature of chest pain: angina is not a painful sensation, but a crush-like boredom, distension or indescribable discomfort in the precordial region. Chest pain due to non-anginal pain is manifested as pain, lightning-like pain, stabbing pain, etc. -Pain duration: A typical angina attack is often 3 to 5 minutes, usually no more than 15 minutes, and can be relieved by rest or nitroglycerin. If severe chest pain lasts for more than half an hour without relief, myocardial infarction or aortic coarct may have occurred, both of which are fatal and require immediate resuscitation. If the chest pain lasts only a few seconds and passes, it is often intercostal neuralgia. Chest pain that lasts for days or months without other manifestations is also unlikely to be angina pectoris. -Onset condition: Angina pectoris often occurs during labor, exertion, emotional excitement, bowel movements, exertion, and other times when myocardial oxygen consumption increases, while chest pain not due to angina pectoris often occurs at rest or leisure. -Chest pain accompanying symptoms: Angina pectoris patients often have general weakness, cold sweat, palpitations at the onset, and in severe cases, blood pressure drops, shortness of breath, and a sense of imminent death. In non-anginal patients, there may be no obvious systemic symptoms during the onset of chest pain. Chest pain caused by the digestive system is more common in gastroesophageal reflux disease, with a burning sensation in the lower part of the sternum and upper abdomen, often described by patients as “heartburn”, aggravated by hiccups, and also aggravated by lying down, with no special changes in the electrocardiogram during painful episodes, and easy to occur after a full meal or when lying down. The pain in the upper abdomen caused by overeating, resulting in acute cholecystitis and acute pancreatitis, may also be reflected in chest pain. Some patients with gastric ulcer and duodenal ulcer may also have some symptoms of chest pain. Chest pain caused by cervical spine discomfort Chest pain caused by cervical spine discomfort has its own characteristics: first, the chest pain lasts for a long time; second, it is accompanied by shoulder and back pain, upper limb distension and numbness; third, the chest pain is related to poor posture, and it will develop whenever this poor posture is maintained for a long time; fourth, the effect of containing nitroglycerin when chest pain is poor; fifth, the effect of treatment according to the regular coronary heart disease is poor. Chest pain caused by respiratory system Chest pain may also be a disease of the respiratory system, possibly pleurisy, where the patient will feel sudden stabbing pain, aggravated by coughing, with pleural friction sounds on auscultation. Or it may be tracheobronchitis, in which the patient experiences discomfort near the midline of the chest that is aggravated by coughing. Spontaneous pneumothorax is most often seen in thin and tall young adults, and typically presents with sudden onset of chest pain, accompanied by chest tightness, breath-holding, coughing, and sometimes shortness of breath, a feeling of suffocation, irritability, and shock. What should I do if I have chest pain? Improper disposal of patients with chest pain is mostly related to the lack of medical knowledge of patients about chest pain. After the occurrence of chest pain, patients need to sit or lie down immediately on the spot to rest, and when relieved, they should be sent to hospital immediately for consultation and treatment, and should never walk home or walk to hospital to avoid sudden death and other serious events. Because when chest pain occurs, the heart vessels may spasm or occlusion, and the heart is in acute ischemia, resting in place can slow down the number of heartbeats and reduce the load on the heart, reduce oxygen consumption, reduce the degree of damage to the heart ischemia and hypoxia, which is important for maintaining heart function. Then seek medical attention early to confirm the condition and treat it early.