After coronary artery disease and gastroesophageal reflux, the next most common cause is musculoskeletal chest wall syndromes. Around 70 percent of these patients have chest wall tenderness on palpation that in up to 16 percent can resemble classical angina.101 The most common areas of musculoskeletal chest pain are sternum, xiphoid, left costosternal junctions, and left anterior chest wall.101
A musculoskeletal cause for a chest pain is suspected when the pain is specific of certain postures or movements or activities. Physical examination often finds tenderness to palpation over the structure that is the source of the pain.102
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