Paroxysmal pain in the upper part of the heart may be due to trauma, pleurisy, angina pectoris, intercostal neuritis, pneumothorax and so on. 1. Trauma: the area above the heart suffers from severe impact, extrusion, abrasion and other traumas, resulting in injuries to epidermal tissues, subcutaneous connective tissues and even ribs and thoracic cavity organs, and thus paroxysmal pain in the area above the heart. 2. Pleurisy: due to bacterial infection, autoimmunity, malignant tumor invasion and other factors lead to pleural inflammatory lesions, involving the pleura above the heart, resulting in paroxysmal pain above the heart. 3. Angina pectoris: emotional excitement, excessive activities and other factors lead to increased myocardial oxygen consumption, which induces myocardial ischemia on the basis of coronary artery stenosis and angina pectoris attack, resulting in paroxysmal pain in the upper part of the heart. 4. Intercostal neuritis: Neuroinflammatory lesions of the intercostal nerves occur after infection or trauma, resulting in radiating pain along the rib distribution. When the intercostal nerves above the heart are involved, there is paroxysmal pain above the heart. 5. Pneumothorax: After a break in the left chest wall or lung surface, outside air enters the pleural cavity and causes an increase in pressure in the pleural cavity, resulting in paroxysmal pain over the heart. Paroxysms of pain over the heart may be related to a variety of factors, and it is recommended to consult a doctor for a clear diagnosis.