Agitated loud talking chest pain, mainly consider the following reasons: 1, acute pericarditis. This pain is often associated with loud talking or coughing and other factors, in addition to chest pain, can also be radiated to the neck, the left side of the shoulder back or even the left upper limb, causing pain in these areas, check the heart ultrasound helps to clarify the diagnosis. 2, acute pleurisy. This kind of pain is mainly associated with loud talking and other factors related to respiratory movement, especially when deep breathing or coughing, the pain is more likely to intensify, perfect chest CT can help to clarify the diagnosis, the pain is serious you can take painkillers, commonly used such as diclofenac sodium. 3, coronary heart disease myocardial ischemia. This patient is mainly due to the narrowing of the heart blood vessels lead to insufficient blood supply to the heart, emotional excitement is prone to increase myocardial oxygen consumption, causing symptoms of chest pain, improve the electrocardiogram, cardiac ultrasound can help to clarify the diagnosis.