If a patient has pain in the upper part of the back that is associated with the chest, the first consideration is high-risk chest pain, such as acute pulmonary embolism, or aortic coarctation, tension pneumothorax, or acute coronary syndrome, which can cause pain in the upper part of the back that is associated with the chest and can be torn and severe. The patient’s pain does not change with the change of position, and will show a gradual increase in symptoms, it is necessary to go to the hospital quickly, and once diagnosed, hospitalization. If the patient has the above mentioned pain, but the pain changes with breathing, respiratory diseases such as open pneumothorax, traffic pneumothorax, in addition, large pleurisy, pleural effusion and lung infection, will also have this symptom. Finally, if the involvement-like chest pain in the upper part of the back is accompanied by pain in the left upper extremity of the patient, it is important to consider coronary artery disease with unstable angina pectoris.