Pain in the thoracic region ranging from mild discomfort to a sharp stabbing sensation, caused by medication use (migraine medication, nicotine patch, calcium antagonists) or exposure to toxins or drugs (alcohol, cocaine).

First-line management is to remove or change the causative medication, monitor carefully for pulmonary or cardiac impairment or insufficiency, and treat other drug-induced adverse effects that may contribute to the chest pain, such as cardiomyopathy, arrhythmias, angina, conduction disorder, or esophagitis. Additional therapies will depend on the cause and the presenting signs and symptoms.