If a patient presents with chest tightness accompanied by back pain, the following points should be considered: First, firstly, high-risk chest pain should be considered, such as acute coronary syndrome, tension pneumothorax, aortic coarctation or pulmonary embolism. Although the incidence of the above-mentioned diseases is low but the mortality rate is high, if the patient has significant back pain, he/she must go to the hospital quickly. Second, if it is the four diseases mentioned above, hospitalization is required for treatment, such as medium-risk chest pain, which commonly includes coronary heart disease, severe arrhythmia, heart failure, acute myocarditis, and acute pericarditis, these conditions will also have symptoms of chest tightness, dyspnea, and shortness of breath accompanied by back pain. Thirdly, for respiratory system diseases, such as massive pneumonia, pleural effusion, pleurisy, this clinical manifestation will also be present at this time. Fourthly, if the patient develops cardiac neurosis, especially in the case of plant nerve dysfunction, the above symptoms will also be present.