Why would i have chest pains that spread all the way down to my back?

Chest pain: Those symptoms might be just due to musculoskeletal pain which is a benign condition. However might be something more serious if you have history of high blood pressure or if you have family history fo marfan's.

Rule out two things: Two worrisome causes for such pain that have to be ruled out are angina/ heart attack and thoracic aortic aneurysm or dissection. Acute episodes of such pain need immediate evaluation in the emergency room.