Hidden pain over the heart has more causes and may be due to coronary heart disease, mediastinal inflammation, bronchial dilatation and so on. 1. Coronary heart disease: angina pectoris occurs when myocardial ischemia is caused by mild narrowing of the coronary arteries. This pain is radiating and can cause vague pain over the heart. 2. Mediastinal inflammation: Inflammation of the upper mediastinum may be caused by injury or infection of neighboring organs. Inflammatory stimuli may damage the tissues above the heart, resulting in vague pain above the heart. 3. Bronchial dilatation: The bronchial dilatation may be caused by the destruction of the airway structure due to infectious factors. If the dilated area is at the tip of the left lung, the infection may cause the pleura to pull, resulting in tenderness over the heart. It is recommended to consult a doctor for further examination to identify the cause of the pain over the heart, and to treat the cause of the pain with the help of the doctor.