Hypothyroidism caused by Hashimoto’s thyroiditis may cause chest tightness and prompt medical attention is recommended. Hashimoto’s thyroiditis is an autoimmune disease, which may cause the thyroid gland to produce too little hormone and lead to hypothyroidism. The onset of the disease is insidious, the course of the disease is long, and most of the patients do not have specific symptoms for a short period of time, with the progression of the disease there may be a chills, fatigue, pericardial effusion, heart failure, and severe mucous edema coma may occur. When a patient develops heart failure, symptoms such as chest tightness, heart fatigue after activity, and shortness of breath may occur. Patients with hypothyroidism who experience symptoms such as chest tightness and dyspnea should immediately consult the endocrinology department for further improvement of cardiac ultrasound, chest CT, blood gas analysis, nail function and other tests, and attention should be paid to differentiating from coronary atherosclerotic heart disease and lung infection.