Pain in the back of the left scapula can be caused by heart disease, such as myocardial infarction and coronary syndrome (coronary heart disease).
Patients may experience pain via visceral nerve involvement to the back of the scapula due to insufficient coronary blood supply and myocardial ischaemia and hypoxia. Therefore, patients who present with pain in the precordial region, chest tightness, palpitations, dizziness and shortness of breath should seek prompt medical attention, lie flat, seek emergency medical attention by car or call 120 for a definitive diagnosis by electrocardiography and coronary angiography.