Tingling like pins and needles in the middle of the chest may be caused by trauma, intercostal neuralgia, coronary artery disease and other reasons. 1. Trauma: If the chest area is traumatized, resulting in damage to the sternum, ribs, muscles, blood vessels and nerves, leading to a stabbing pain like pins and needles in the middle of the chest. 2. Intercostal neuralgia: the intercostal nerve is the main nerve in the chest, and damage to the intercostal nerve will trigger a syndrome of striated pain in the intercostal area of the chest, which may lead to pins and needles pain in the middle of the chest, which is mostly persistent. 3. Coronary heart disease: coronary atherosclerosis can cause coronary artery stenosis, which may cause myocardial ischemia, hypoxia, angina pectoris, manifested as a pinprick-like pain in the middle of the chest. Patients with pins and needles pain in the middle of the chest should go to the regular hospital in time to clarify the cause of the disease and give targeted treatment under the guidance of a professional doctor.