Occasional stabbing pains in the heart, like pins and needles, may be caused by heart disease, or may be caused by intercostal neuralgia, costochondritis and other non-heart problems. 1. Heart disease: It is easy to appear when you are tired or emotionally excited, due to insufficient blood supply to the heart muscle, heart tingling occurs, often lasts for a long time, can be a few seconds to a few minutes, and often accompanied by chest tightness, shortness of breath and other symptoms, you need to do an electrocardiogram and other tests, to make a clear diagnosis. 2. Non-cardiac diseases: with intercostal neuralgia, costochondritis, there will also be occasional stabbing pain in the precordial area, like pins and needles, the duration is relatively short, usually a flash, and costochondritis, when pressed, there will be pain in the corresponding cartilage area. There is heart pain like pins and needles, must pay attention to, especially when accompanied by chest tightness and shortness of breath, it is recommended to go to the hospital in a timely manner, under the guidance of the physician, to clarify the cause of the targeted treatment given.