If the patient has obvious pain in the middle of the upper end of the sternum, the specific reasons are as follows: firstly, it should be considered whether the patient suffers from trauma, if there is a fracture of the sternum or ribs there will be pain symptoms in the middle of the upper end of the sternum, such as contusion, laceration caused by trauma, etc., there will also be a sense of pain in the above area. Secondly, if the patient has previous coronary artery disease, it should be highly considered whether the patient has coronary artery disease combined with unstable angina, usually the patient will have pain symptoms in the upper part of the sternum or the posterior side of the sternum. Then, respiratory diseases should also be considered, such as pneumothorax, pleural effusion, massive pneumonia, or the presence of pleurisy can also present with painful symptoms in the middle of the upper sternum. Finally, for some rare diseases, such as intercostal neuralgia or shingles pain, pain can also be experienced in the above area.