There are many causes of posterior back pain behind the heart, including angina pectoris, cervical spondylosis, fasciitis, pulmonary lesions, and herpes zoster. Patients with posterior back pain need to determine the cause based on clinical symptoms and relevant tests. If the patient has a posterior sternal or left precordial area pressure or constriction-like pain after exertion or emotional excitement, accompanied by back pain, with abnormal changes such as ST-segment depression suggested by electrocardiogram during the attack, and the pain is significantly relieved after rest or with medication such as nitroglycerin, this condition should be considered to be caused by angina pectoris. If the patient’s posterior back pain and discomfort, muscle stiffness, rainy days or after cold symptoms significantly aggravated, after appropriate activities or taking non-steroidal anti-inflammatory drugs such as diclofenac sodium pain relief, this condition should be considered fasciitis may.