There are many reasons for the pain that occurs in the middle of the two chests. If the pain appears above the middle of both chests in middle-aged and older women, consider angina pectoris. However, if the above symptoms occur in younger women, angina pectoris is not considered. Because the age of onset of angina is middle-aged and older patients, for young women is unlikely to have angina caused. There are many causes of pain in the middle of the chest, such as intercostal neuralgia or chondromalacia, which can cause pain. If the patient has GERD, pain behind the sternum can also occur because the esophagus is located behind the sternum, but the pain caused by GERD is related to eating or fasting, and the pain is a burning sensation.