The organs in the chest cavity include the pleura, lungs, pericardium, heart, trachea, esophagus, and thoracic spine. Lesions in any part of these organs can cause chest tightness and chest pain. Lesions outside the chest such as the cervical spine, stomach, biliary tract and other parts of the body can also cause chest tightness and chest pain. Common causes of chest tightness and chest pain include heart disease, lung and pleural diseases, gastroesophageal reflux disease, etc. 1, heart disease: the most common cause of heart disease that causes chest tightness and chest pain is coronary heart disease (angina or infarction), angina due to myocardial ischemia and hypoxia caused by narrowing or occlusion of coronary arteries. It is mostly associated with exertion, emotional excitement, and full meals, and can be relieved by rest or nitroglycerin inhalation. Cardiac enzymes, troponin, electrocardiogram, echocardiogram, coronary CT, cardiac MRI or coronary angiogram can further diagnose heart disease problems. Second, myocarditis and pericarditis can also cause chest tightness and chest pain. Viral myocarditis may be preceded by a history of upper respiratory tract infection, and arrhythmias are common. The chest pain symptoms of pericarditis are mostly related to breathing, coughing, body position or swallowing. 2, lung and pleural diseases: more common lung infections, spontaneous pneumothorax, pleurisy, lung cancer, etc. Spontaneous pneumothorax often has tearing-like pain when it first occurs. When inflammation invades the pleura, it shows as pinprick-like pain. Lung cancer is persistent and severe pain. Pain due to pulmonary causes is mostly aggravated by breathing or coughing. The diagnosis can be further confirmed by chest X-ray, lung CT, bronchoscopy, etc. 3.Gastroesophageal reflux disease: Gastroesophageal reflux disease is caused by reflux of gastroduodenal contents into esophagus causing discomfort. It is often accompanied by acid reflux and heartburn, and is aggravated when lying down or when abdominal pressure is elevated. Gastroesophageal reflux can cause chest pain without heartburn and reflux, which is not easily distinguished from the pain of ischemic heart disease. It can be clarified by barium meal examination, gastrointestinal endoscopy or B-ultrasonic examination. 4.Psychological factors: Cardiac neurosis and psychological factors can also cause similar symptoms. Cardiac neurosis and psychological factors can be considered under the condition that no clear cause can be found after careful examination. There are many reasons for chest tightness and chest pain, so patients should not diagnose and use medication on their own, and it is recommended to consult a regular hospital.