Chest pain can have many causes. Pain can come from the heart, lungs, gastrointestinal tract, muscles and bones of the chest wall, or abnormalities in nerve pain sensation. It is often difficult to distinguish one type of chest pain from another. There are many tests that can be done to help distinguish the different types of chest pain so that the correct treatment can be given. Because heart disease continues to be a major cause of death and disability, chest pain due to disease of the coronary arteries (arteries that supply the heart) is of particular concern. It is helpful to know the signs and symptoms that suggest cardiac (associated with the heart) chest pain (see below). Cardiac chest pain is called angina , is due to blockages or dysfunction in the coronary blood vessels (arteries and small artery branches called arterioles), and is usually related to physical exertion or stress. Not everyone has the same symptoms, and women often have atypical (different) symptoms compared with men. Risk factors for angina include high cholesterol, diabetes, smoking, high blood pressure, and a family history of coronary artery disease. The April 8, 2009, issue of JAMA includes an article about cardiac causes of chest pain.