There are many causes of pain right in the middle of the sternum; heart disease, chest disease, and esophageal disease can cause pain right in the middle of the sternum. 1. Heart disease: angina pectoris, myocardial infarction and other heart disease attacks, can appear in the anterior chest area of the colic, but also at the same time with palpitations, dyspnea and other symptoms. 2. Chest diseases: the pain in the middle of the sternum can be caused by external impact or extrusion of the sternum, or local soft tissue injury or tumor of the sternum. 3. Esophageal diseases: Reflux esophagitis, esophageal cancer and other diseases cause the esophagus to be attacked, which can be manifested as pain in the middle of the sternum. It may be accompanied by difficulty in swallowing, nausea and other symptoms. If the pain persists in the middle of the sternum, you should consult the doctor as soon as possible for a clear diagnosis and symptomatic treatment.