We are all no strangers to hospitals, and we often see the words priority for chest pain patients. The reason why there is such a rule is that the higher risk of chest pain patients is on the one hand, and on the other hand, because of its commonness, the large base of the disease has also led to an increase in the number of deaths, which has made us pay more and more attention to the problem of chest pain. Chest pain is a very common symptom, and there are many causes of chest pain, including cardiac, respiratory, digestive, muscular, neurological, spinal, and many other causes, in the hospital, often encountered patients who come to the doctor because of chest pain. Next we unveil the mystery of chest pain one by one: First, acute myocardial infarction. It is one of the clinical manifestations of coronary atherosclerotic heart disease, but also the most critical, although there is also the possibility of angina pectoris, but the two symptoms are similar, infarction is more representative. Coronary artery is the only source of myocardial blood supply, when it occurs atherosclerosis, the formation of atherosclerotic plaque, resulting in reduced vascular elasticity, lumen narrowing, myocardial ischemia ischemia and hypoxia, which occurs necrosis, and myocardial cells can not be regenerated once the necrosis, so the consequences of the myocardial cells are necrotic, the myocardial contraction is weakened or disappeared, the person will be in critical condition. So when the hospital received chest pain patients need to immediately monitor vital signs, immediately do electrocardiography, if you see obvious ST-segment elevation or depression, pathologic Q wave, T wave changes, then the possibility of infarction is very large, for further diagnosis need to immediately check the cardiac enzymes, if found troponin positive patients, then we can judge the patient for the infarction patients. Tension pneumothorax. When the rupture of pleural cavity forms a “living flap” where gas can only enter but not exit, the pleural cavity will accumulate more and more gas, and the negative pressure in the thoracic cavity will disappear very quickly, resulting in severe lung compression and ventilation restriction, and at the same time, the venous return will be impaired, and the effective blood volume will fall rapidly, which will soon be life-threatening. Therefore, when we received the patient, we immediately asked the patient whether he had chest trauma or asthma, emphysema and other medical history, and closely monitored the patient’s respiratory status, and observed whether he had jugular vein varicose and other clinical manifestations. Once the diagnosis is confirmed, immediately puncture and ventilate, and promptly perform closed chest drainage. Third, pulmonary embolism. Patients who have been bedridden for a long time and have obvious swelling and pain in both lower limbs are prone to deep vein thrombosis of the lower limbs. Once the thrombus formation, dislodgement, through the blood circulation to reach the right ventricle, and then embolized pulmonary artery, can appear pulmonary infarction, patients often have chest pain, coughing up blood, dyspnea triad. If you encounter such patients, immediately check the D-dimer, rapid lower extremity vascular ultrasound or CT pulmonary arteriography, clear whether there is obvious thrombosis, as well as the site of embolism, once diagnosed actively rescue treatment. Fourth, spinal origin disease. It is due to the compression of the nerve root or nerve root canal stenosis after the disc herniation, resulting in the compression and stimulation of the nerve root, so that the nerve continues to be excited, affecting the innervation of the compression of the coronary artery, so that it gradually spasmodic constriction, so that the myocardium will be due to hypoxia and ischemia, and chest pain occurs. Such patients, if detected in time, should take treatment measures as early as possible, first to the hospital to do cervical spine magnetic resonance examination, to understand the degree of nerve compression, the range of nerve compression and the site of nerve compression, and then find the lesion for surgical elimination, and at the same time need to release the nerve excitability. In conclusion, when facing patients with chest pain, vital signs are the first place, electrocardiogram is the fastest means of examination, imaging examination (vascular ultrasound, angiography or MRI), laboratory examination (cardiac enzymes, troponin, D-dimer) can’t be left behind, and then combined with the history, symptoms, signs, rapid judgment of the category of chest pain, and actively give rescue treatment, is the key for us to overcome the grim reaper.