When you get up and have pain in the middle of your chest, the following causes are mainly considered: 1. cardiac causes, the most common is angina pectoris in coronary heart disease, some of these patients may have previously had risk factors such as hypertension, hyperglycemia, hyperlipidemia, smoking, etc., and have pain in the middle of the chest under activity, examination of ECG and cardiac ultrasound helps to make a clear diagnosis. 2. respiratory system diseases, the most common is pneumothorax, such patients often have The most common respiratory disease is pneumothorax, which is often triggered by strenuous activity, sudden exertion, etc., followed by chest pain, some may also be accompanied by chest tightness and dyspnea, examination of chest X-ray can help clarify the diagnosis. 3, digestive system diseases, the most common is reflux esophagitis, the attack of this disease is similar to angina, easy to attack at night, but the patient is often accompanied by acid reflux and other manifestations, examination of the upper gastrointestinal tract barium meal can help clarify the diagnosis.