There are many causes of heart pains, including coronary artery disease, esophageal spasms, and cardiac neurosis. A bout of pain is known in medical terminology as paroxysmal pain, which means that the pain is present for a while, relieved for a while, and can disappear completely when relieved. This condition is usually caused by smooth muscle spasm or blood vessel narrowing ischemia. Pain caused by inflammation, tumor embolism, etc. is mostly persistent and cannot be relieved. 1, coronary heart disease: coronary heart disease is caused by myocardial ischemia and hypoxia or necrosis due to coronary artery stenosis or occlusion, which is clinically manifested as chest tightness and chest pain. Coronary artery spasm can also cause myocardial ischemia and hypoxia. Episodic chest pain is the characteristic of angina pectoris. Chest pain is mostly related to exertion, emotional excitement, full meal, etc. It can be relieved by rest or nitroglycerin intake. People with hypertension, diabetes, hyperlipidemia, obesity, smoking history and family history of coronary heart disease need to be alert to the possibility of coronary heart disease if they have episodic chest pain. Further diagnosis of heart disease problems can be made through tests such as cardiac enzymes, troponin, electrocardiogram, echocardiogram, coronary CT, cardiac MRI or coronary angiography. 2, esophageal spasm: The esophagus is near the location of the heart, so the symptoms of esophagus can also be manifested as pain in the heart area. The main symptom is chest pain, which varies in nature and degree, and can be manifested as swallowing pain, or angina-like symptoms in severe cases, which can appear when eating or when emotional, or can appear spontaneously, and the pain can radiate to the back of the neck and shoulders, with varying duration, and can be relieved by sublingual nitroglycerin, which can easily suggest angina pectoris. Most patients have dysphagia, but unlike organic obstruction, the symptoms are recurrent in nature. Patients with chest pain onset have no abnormal electrocardiographic examination, and the presence of dysphagia suggests esophageal-derived chest pain. Esophageal manometry is of greater diagnostic significance. 3, cardiac neurosis: mostly occurs in young and strong women, especially menopausal women. The symptoms are various, there can be chest pain, the pain site is not fixed, mostly in the precordial area, the pain attack is not related to exertional activities, most of them occur in the resting state, the nature of the pain is often needle-like, pulling-like or cutting-like, the duration is variable, generally longer, and cannot be relieved by nitroglycerin. Cardiac neurosis is difficult to diagnose based on symptoms, and organic diseases must be excluded before a diagnosis can be made. Since there are many organs in the heart, patients should not diagnose themselves with medication based on symptoms alone, and regular hospital consultation is recommended.