There are many diseases that may cause chest tightness and back pain, including heart disease, lung disease, esophageal disease, pancreatic disease, etc. may have such symptoms, and the specific situation should be judged according to the accompanying symptoms and past medical history. Diseases that may cause chest tightness and back pain are as follows: 1. Cardiovascular system diseases: coronary heart disease (angina pectoris, heart attack, myocarditis, pericarditis, aortic coarctation, pulmonary artery embolism, etc.). Cardiac enzymes, troponin, electrocardiogram, echocardiogram, coronary CT, cardiac MRI or coronary angiogram can be used to clearly exclude heart disease problems. 2, digestive system diseases: gastroesophageal reflux disease, esophageal hiatal hernia, esophageal cancer, peptic ulcer, biliary tract disease chronic pancreatitis, acute pancreatitis, occupying lesions of the pancreas. It can be clarified by gastrointestinal endoscopy or ultrasound examination. 3.Respiratory system diseases: bronchial lung cancer, tuberculous pleurisy and other lung diseases. Back pain may be caused by inflammation or cancer cells affecting the pleura and causing pain. The diagnosis can be clarified by chest X-ray, lung CT, bronchoscopy and other examinations. 4.Neuro-skeletal system: cervical spondylosis, intercostal neuralgia, etc. 5, psychosomatic factors: cardiac neurosis and psychological factors. Cardiac neurosis and psychological factors can be considered under the condition that no clear cause can be found after careful examination. When chest tightness and back pain are found, cardiovascular system diseases must be ruled out first, because heart attack, aortic coarctation and pulmonary embolism may lead to death if not treated in time. Regardless of the condition causing chest and back pain, patients need to be seen in the hospital as soon as possible to rule out critical illnesses of cardiopulmonary disease.