There are many reasons for pain in the back where the heart is located: 1, except if it is a heart attack, such as angina attack, there can be pain in the precordial region, then radiating to the back, radiating to the shoulder, pain in this place can be an angina attack. 2, different ages, such as children or teenagers, may be mainly congenital, such as occult spina bifida. 3, too much daily activity, trauma in this place, or different occupations, such as manual laborers, especially strong manual laborers, injury to this place can be painful; in addition the back is too straight when driving in a dead machine, which can cause pain in this place. 4, intercostal neuritis. 5, see if there is herpes on the skin, such as shingles, can cause pain in this place.