From WardWiki - Foundation Doctor Helper
Chest pain is an extremely common presentation that ranges from the trivial muscle attack to fatal ACS or aortic dissection. management is essentially one of being thorough and NOT taking shortcuts. This is essential until sufficient experience is gained to quickly exclude trivial cases; this takes time and rarely gained during foundation years 1 and 2.
Investigate for the very common, the easy to exclude and the downright dangerous. This includes the following though this list is not exhaustive. Do not be pressured to discharge unless you are absolutely sure no serious pathology is present; always contact a senior before discharging for EVERY case. This will give some cover and comfort and ensure the work done is not in isolation from experienced clinicians.
Common causes of chest pain
It is important to note that a heart attack can present in many ways. Don't assume the classic central crushing chest pain of medical textbooks is universal; it most certainly is not and almost 20% of MI are painless.