Another, benign cause for chest pain is Costochondritis, an irritation of the ribs and sternum after strenuous physical activity, heavy lifting, or a blow to the chest. The pain is present—or can be recreated—by movement of the patient's chest, shoulders, or arms, by palpation during a physical exam, or by coughing. Costochondritis is treated with rest and NSAIDs.
Substernal chest pain you should be concerned about is usually different: Think pressure or squeezing. Non-tender. Non-traumatic. Persistent, not relieved by movement. This is especially true if the patient has a history of cardiac problems, is on cardiac meds, and the pain is accompanied by sweating, shortness of breath, and unusually pale skin. Pain linked to a heart attack may also mimic indigestion and radiate to the patient's neck, arms, or back. In these cases, seek immediate medical assistance.