If a patient has chest pain and shoulder and back pain at the same time, first of all, trauma should be ruled out as a result of trauma, such as impact injuries, contusions, fractures of the sternum and ribs or sprains and contusions of the soft tissues of the shoulder joint, which can trigger the above pain. Secondly, if the patient has coronary artery disease or unstable angina, the pain will be radiating behind the sternum to the left side of the shoulder and back, and the pain will be compressive strangulation pain, accompanied by chest tightness and shortness of breath, and also have symptoms of dyspnea. After excluding the above, other high-risk chest pains such as tension pneumothorax, pulmonary embolism, and aortic coarctation should be considered, which have low morbidity but high mortality. Finally for uncommon diseases, such as intercostal neuralgia and herpes zoster pain, the above symptoms can also occur.