If the chest
wall is tender to the touch, or if the pain
occurs with movement
of the shoulder, arm, etc, then a musculoskeletal cause is suspected. If the chest discomfort is related to eating, then gall bladder disease is suggested. If an empty stomach causes symptoms, then reflux of stomach acid or ulcer disease can be the culprit. It may seem strange that these examples of gastrointestinal disease can be experienced as chest discomfort, but it is not at all unusual.