Chest tightness, heartburn and back pain can be seen in gastroesophageal reflux disease (GERD), chronic gastritis, heart disease, lung disease and so on. 1. Gastroesophageal Reflux Disease (GERD): It is a disease in which the gastric content refluxes due to the impaired anti-reflux ability and function of the esophagus, or the reduced clearance ability and mucosal defense ability. Typical symptoms are acid reflux and heartburn. When gastric contents reflux into the esophagus, it will irritate the esophageal mucosa, resulting in symptoms of retrosternal pain and chest tightness, and the pain can also radiate to the back and shoulder blades and other parts of the body. 2. Chronic gastritis: Chronic gastritis is usually accompanied by excessive secretion of gastric acid. When gastric acid refluxes into the esophagus, it stimulates the esophageal mucosa, which can cause heartburn and retrosternal pain, accompanied by symptoms of chest tightness and back pain. Some patients also have belching, nausea and vomiting, loss of appetite and other symptoms. 3. Heart disease: such as angina pectoris, coronary artery disease, etc., during the attack, there will be obvious symptoms of chest tightness, pain in the precordial area, and the pain will radiate to the back, and some patients will also experience heartburn. 4. Lung diseases: such as pneumonia, lung tumors, etc., will affect the patient’s breathing, chest tightness symptoms, while inflammation, tumors, etc. on the lungs caused by stimulation, can appear chest pain or back pain. It is recommended to seek timely medical treatment for the above symptoms, identify the causes under the guidance of professional physicians and carry out targeted treatment to avoid delaying the condition.