胸痛的原因很多，有心臟血管病引起的，有肺或胃腸疾病引起的，有肌肉、骨骼、神經病變引起的，也有心理、情緒壓カ引起的》醫師會根據病史、聽診、觸診、身體檢查及 血液檢查等所見，加以鑑別診斷。此時常常須藉助心電圖、胸部X光及超音波等檢查，必要時須做運動式心電圖、核子心肌灌流、上消化道纖維鏡等檢查，有時也須藉助侵襲性心導管檢查，才能獲得正確的診斷。但是，不管是内科醫師、急診醫師，尤其是心臟科醫師面對以胸痛為初次症狀呈現出來的病人，除了要確認是否因心臟病引起之外，對已排除心因性胸痛之病患，還要全方位思考是否有潛藏癌症的可能，要小心將癌症列入胸痛鑑別診斷之重要原因之一。

Chest pain is a frequent complaint of patients seeking urgent medical assistance. It is a serious concern for patients and practitioners because of its potentially life-threatening implications, and misdiagnosis can be fatal. The shared neurologic pathways of thoracic and abdominal visceral organs complicate the diagnosis of chest pain. It is vital that patients presenting with chest pain are rapidly and skillfully assessed so that the correct working diagnosis including malignancy can be made and appropriate treatment offered. (J Intern Med Taiwan 2013; 24: 413-417)