Stabbing pain like pins and needles in the heart may be caused by pleurisy or myocarditis. 1. Pleurisy is usually caused by parasites, fungal infections, trauma or pneumonia, and is usually accompanied by weakness, cough, chest pain, chest tightness and other symptoms, and in severe cases, even dyspnea and fever. You can take ethambutol tablets, cefaclor tablets, levofloxacin and other drugs under the guidance of the doctor for treatment, and at the same time, you should avoid emotional anxiety, pay attention to balanced nutrition, avoid smoking, alcohol and stimulating food. 2. Overwork, bacterial infection, drug stimulation or fungal infection is usually the main cause of myocarditis, usually accompanied by chest pain, chest tightness, dizziness, palpitations, shortness of breath and other conditions, and in severe cases may even cause dyspnea or lower limb edema symptoms. One should go to the hospital in time for symptomatic treatment and follow medical advice.