Heart tingling like pins and needles is mostly caused by diseases; it can be categorized into cardiovascular system, respiratory system, and psychological diseases. 1. Cardiovascular system: common coronary heart disease, myocarditis and so on. (1) Coronary heart disease: also called coronary atherosclerotic heart disease. When the patient’s condition flares up, there may be chest pain or angina. The manifestations are such as stabbing pain in the anterior region of the heart. (2) Myocarditis: inflammation that occurs in the heart muscle cells. Patients may have chest tightness, chest pain and other manifestations. 2. Diseases of the respiratory system: for example, pleurisy, pneumothorax, pneumonia and so on. (1) Pleurisy: inflammation that occurs in the pleural cavity. Patients will have tingling or pulling pain. It is also accompanied by coughing and dyspnea. (2) Pneumothorax: It is a state of accumulation of gas caused by gas entering the pleural cavity. Patients with pneumothorax on the left side will suddenly feel a pinprick pain in the heart area, accompanied by chest tightness, dyspnea and so on. (3) Pneumonia: when there is pneumonia infection on the left side, there may be pinpoint pain in the heart area, accompanied by fever, cough and other symptoms. 3. Mental illness: mainly seen in the heart of neurosis; the patient consciously have obvious symptoms of discomfort, but there is no obvious abnormality in the various indicators of the examination. Patients with stabbing pain in the heart like pins and needles are recommended to go to the hospital; identify the cause of the disease and cooperate with the treatment under the guidance of the doctor.