Heart pain after drinking alcohol cannot be ruled out as a reaction to alcohol intoxication or excessive sympathetic excitation caused by drinking alcohol; at the same time, it cannot be ruled out as a result of underlying diseases, such as coronary artery atherosclerosis. 1. Alcohol poisoning: If drinking too much alcohol causes alcohol poisoning, toxic myocarditis may be induced, which will eventually cause heart pain and be accompanied by symptoms such as chest tightness, shortness of breath, dyspnea and so on. 2. Sympathetic nerve excitation: after drinking alcohol, some patients may experience excessive excitation of the sympathetic nervous system, and when the heart load increases, it may affect the normal activity of myocardial electrocardiography, thus causing heart pain, which belongs to the heart pain without organic lesions. 3. Coronary artery atherosclerosis: a kind of organic heart disease, when drinking alcohol will lead to increased cardiac load, triggering myocardial hypoxia, further aggravation of the condition will cause angina pectoris. If you suddenly have heart pain after drinking, it is recommended that you seek medical attention as soon as possible and analyze the cause under the guidance of a professional physician to exclude pathological factors in a timely manner in order to prevent the condition from worsening.