[Chest pain as the presenting symptom in the emergency department]

Chest pain is a common and clinically pivotal presenting symptom with a broad spectrum of etiologies, ranging from benign conditions to acute life-threatening emergencies. This article outlines a structured approach to the evaluation of chest pain in the emergency department, with particular emphasis on the rapid identification of the "Big Five" critical diagnoses. It further discusses the systematic classification of differential diagnoses and describes how targeted diagnostic and therapeutic measures can be efficiently initiated.