Pain in the middle of the chest and back is seen for many different reasons: First, patients with thoracic aortic aneurysms can present with chest and back pain. The patient should have an underlying history of hypertensive disease as well as atherosclerosis. The seizure phase will show tear-like pain in the chest and back, also accompanied by changes in blood pressure, which can be further identified by performing an enhanced CT of the chest. Second, patients with diseases of lung tissue, such as lung tumors and intrapulmonary infections, may also present with chest pain. Thirdly, patients with mediastinal emphysema, which is very rare, may also present with chest pain and have obvious symptoms of chest tightness and shortness of breath, which can be confirmed by chest X-ray and CT examination. Some patients even have characteristic karate sounds during auscultation on examination. There are also idiosyncratic infections or mediastinal tumors that can manifest as pain in the chest and back.