The paroxysmal pain in the middle of the chest, generally there may be the following conditions: 1, unstable angina or coronary atherosclerotic heart disease, mainly due to spasm or narrowing of the main arteries of the heart, and the ischemia and hypoxia of the heart caused by painful symptoms, patients can clarify the nature of the heart lesion through coronary angiography or coronary CTA. 2, malignant tumors of the breast, malignant tumors will invade the The nerves of chest wall or parasternal lymph nodes, thus causing paroxysmal pain in the middle of chest. In this case, MRI or ultrasound examination of the breast can be improved to clarify the nature of the lesion. 3, choledocholithiasis with cholangitis, the common bile duct is located below the glabellar process, if there is an acute infection, it will manifest as a paroxysmal discomfort in the chest.