Can 痛み also refer to emotional pain? Does only refer to physical pain or can it also mean emotional pain? Could I use it to say something like "What's wrong?" > "I failed the exam. I'm embarrassed and scared." > "I feel your pain." >

Generally, yes, includes non-physical pain.

Typically (or ) means something like _My conscience bothers me_ and not any kind of cardiac problems.

* * *

But, in the particular example you give, is unlikely to be used in the first place. Possible translations would be:

* ()
* ( or )



(Note that these are overly polite when you are talking to friends)