There are more causes of paroxysmal pain in the area above the heart, which may include coronary heart disease, esophageal spasm, cardiac neurosis, etc. Paroxysmal pain is paroxysmal pain, which refers to pain for a while and relief for a while, and the pain can disappear completely when relieved. 1, coronary heart disease: coronary heart disease is caused by coronary artery stenosis or occlusion causing myocardial ischemia and hypoxia or necrosis, and the clinical manifestation is chest tightness and chest pain. Coronary artery spasm can also cause myocardial ischemia and hypoxia. Episodic chest pain is the characteristic of angina pectoris. Chest pain is mostly related to exertion, emotional excitement, full meal, etc. It can be relieved by rest or nitroglycerin intake. People with hypertension, diabetes, hyperlipidemia, obesity, smoking history and family history of coronary heart disease need to be alerted to the possibility of angina if they have episodic chest pain. Cardiac enzymes, troponin, electrocardiogram, echocardiogram, coronary CT, cardiac MRI or coronary angiogram can further diagnose heart disease problems. 2. Esophageal spasm: The esophagus is near the location of the heart, so the symptoms of esophagus can also be manifested as pain in the area above the heart. The main symptom is chest pain, which varies in nature and degree, and can be manifested as swallowing pain, or in severe cases as angina-like symptoms, which can appear when eating or when emotionally agitated, or can appear spontaneously, and the pain can radiate to the back of the neck and shoulders, with varying duration, and can be relieved by sublingual nitroglycerin, which can easily suggest angina. Most patients have dysphagia, but unlike organic obstruction, the symptoms are recurrent in nature. Most patients have no abnormal ECG examination during the onset of chest pain, and the presence of dysphagia suggests esophageal-derived chest pain. Esophageal manometry is of greater diagnostic significance. 3, cardiac neurosis: mostly occurs in young and strong women, especially menopausal women. The symptoms are various, there can be chest pain, the pain site is not fixed, mostly in the precordial area, the pain attack is not related to exertional activities, most of them occur in the resting state, the nature of the pain is often needle-like, pulling-like or cutting-like, the duration is variable, generally longer, and cannot be relieved by nitroglycerin. Cardiac neurosis is difficult to diagnose based on symptoms, and organic diseases must be excluded before a diagnosis can be made. Since there are many organs in the heart, patients should not diagnose themselves with medication based on symptoms alone, and regular hospital consultation is recommended.