Chest tightness, shortness of breath and back pain should consider the following possibilities: First, coronary heart disease, myocardial ischemia, symptoms of chest tightness and shortness of breath, with paroxysms as the main feature, also accompanied by pain in the back, this time to consider the possible occurrence of coronary atherosclerotic heart disease, you should go to the hospital and do an electrocardiogram to clarify whether it is coronary heart disease, if necessary, you can do coronary angiography or coronary CTA to clarify diagnosis. Secondly, the possibility of aortic coarctation should also be considered. Aortic coarctation is mostly seen as pain in the chest and back, with tearing-like pain, tossing and turning, and also accompanied by chest tightness and shortness of breath. If you want to make a clear diagnosis, you must do CTA of the aorta to determine whether there is an entrapment. Thirdly, cervical spondylosis, when cervical spondylosis occurs, there can also be symptoms such as associated muscle aches and pains, and also a series of symptoms of the heart, such as chest tightness and shortness of breath, and at this time, an MRI of the cervical spine is needed to make a clear diagnosis.