It is taken to mean heart pain, although chest pain may be due to cramp, spasm in the chest wall muscles, acid flowing back from the stomach, inflammation of the lung surface (pleurisy), or the start of shingles.
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Rufio, a Breton pilgrim, resides at the Inn of Ill Omen. He is targeted for assassination in the initiation quest for the Dark Brotherhood, A Knife in the Dark. His assassination was arranged by Claudius Arcadia. Rufio will only appear once the quest has been initiated.