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Costochondritis - Feels Like a Heart Attack But It's Not

Always See Your Doctor About Undiagnosed Chest Pain!

First and foremost, it is imperative that you see your doctor about any chest pain that has not been previously diagnosed and is not familiar to you. Remember, only a doctor can tell the difference between a heart attack and something else.

Men and women experience heart disease differently, so be sure to see a doctor familiar with heart disease associated with your gender.

While heart disease can be a cause of chest pain, there are other conditions that your doctor may diagnose as the cause. Costochondritis is a common one.

It is imperative that you see your doctor about any chest pain that has not been previously diagnosed and is not familiar to you. Remember, only a doctor can tell the difference between a heart attack and something else.

What Is Costochondritis Pain?

Costochondritis pain arises when the costal cartilage becomes inflamed, causing pain in the chest area. The pain often radiates outward from the sternum bones that protect your heart. This is why costochondritis can feel like a heart attack.

From my own experience as well as my daughter's, the pain can be mild to overwhelming, accompanied by anxiety and shortness of breath. Trying to relax—easier said than done—can help allay the anxiety so you think about what to do.

Costal Cartilage

White color is the Costal Cartilage
White color is the Costal Cartilage | Source

What is Coastal Cartilage?

The coastal cartilage connects your ribs to your sternum. While it can feel like your ribs are actually attached in the front of your body as well as your spine, they are not.

The cartilage attaches to the rib bone in front and the first seven ribs attach to one of the three bones that make up the sternum. Ribs eight through ten attach to the coastal cartilage from the seventh rib and are called "false ribs." The last two ribs are called floating ribs and have no coastal cartilage.

The purpose of this coastal cartilage is to allow for flexibility in the chest region. Without this, it would be difficult to inhale the needed oxygen and exhale the toxic carbon dioxide. Take a deep breath and feel the ribs move as your lungs expand!

A Pulled Rib Anyone?

Causes of Costochondritis

It can't always be known why the cartilage is inflamed causing the costochondritis. However, it is known that people with fibromyalgia experience it often. Rheumatoid arthritis in certain parts of the body can cause it, as well.

A dislocated or pulled rib may also be the reason. This can happen from very vigorous coughing or repeated trauma to the chest area.

Have You Experienced Costochondritis?

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Who Gets Costochondritis?

Costochodritis is the most common muscular-skeletal reason for chest pain. By and large, women experience it more often than men.According to Medscape.com, only 39% of cases were men.

Those of both sexes over 40 are also more prone to this condition.

Another source, emedicinehealth.com, cites the peak age for costochondritis cases is 12-14 years of age.

This information is somewhat contradictory, but is a good example of how confusing this condition can be.

However, I can speak to both sources' findings as my eldest daughter first started experiencing this at around 11 and I started after 50.

Costochondritis is common among fibromyalgia and rheumatoid arthritis patients. People with Ehlers-Danlos Syndrome (a rare disease my daughters and I have) often experience it, although the connection is not well known in general medicine. In fact, the members of support groups on Facebook (instead of doctors) were helpful in my identifying what my daughter was experiencing.

Costal cartilages (shown in red).
Costal cartilages (shown in red). | Source

Costochondritis Symptoms

Since there are several common conditions that can cause chest pain, it's important to know which symptoms are most closely related to costochondritis.

  • The pain is located centrally near your breast bone, though the pain can radiate around the rib cage to the back
  • If you can push on the costral cartilage near the breast bone, it should be tender. This indicates the inflammation.
  • While many sources of information do not indicate shortness of breath, I have found my daughter gets such stabbing pain that it does actually cause her difficulty catching her breath, almost in the same way as if she'd had the wind knocked out of her - but lasting longer.
  • The pain should respond to heat or cold and also to pain relievers, especially NSAIDs.
  • You may be able to link the pain to lots of coughing, falling, getting hit in a sports activity, or some other kind of trauma to the upper torso.

What you should NOT feel:

  • High fever
  • Pain that radiates up your arm and into your shoulder, jaw and neck
  • Feel like an elephant is sitting on your chest causing tightness and breathlessness
  • Nausea
  • Vague fatigue, especially during rest
  • Sweating, more like the kind from anxiety

Keep in mind, some of these symptoms are more common in women than men.

Relief for Costochondritis

After you have truly ruled out a heart issue, there are some things to do to help you feel better:

  • Rest
  • If you are able, take an NSAID as needed to help with the inflammation and pain
  • Use an ice pack or heating pad (whichever you tolerate best)
  • Avoid activity like impact sports or even sleeping on your side or stomach

If you experience costochondritis often, you may look for a pattern. For instance, if stress or hormonal shifts seem to be associated, dealing with these triggers might be helpful in the long run. If you have localized swelling over the ribs, the condition may be Tietze Syndrome and your doctor should treat you.

Understanding Costochondritis Is Empowering

Waking up in the middle of the night with horrible chest pain is stressful. It can be costly, too, as you rush off to the ER.

I can not stress enough that you MUST follow up with your physician and have tests to verify your heart health. Sometimes, rushed doctors in the ER may think you do not fit the profile for a heart-related condition and may misdiagnose you with costochondritis, instead. You should follow up with your regular physician until tests can rule out a heart condition.

But once you have verified your heart is healthy, you can begin to be less stressed about these bouts. While painful, there are no long-term health effects from costochondritis.

Understanding what is happening and how to feel better is empowering and can help you take control.

Two Funny Physical Therapists Talk Costochondritis

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3 comments

ChitrangadaSharan profile image

ChitrangadaSharan 21 months ago from New Delhi, India

This is very useful and informative hub about chest pain which is not associated with heart. Whenever we have chest pain, we usually get worried that it has something to do with heart.

Thanks for the education. Voted up and pinned!


mbwalz profile image

mbwalz 21 months ago from Maine Author

Thank you ChitrangadaSharan! I'm so amazed that it took us so long to get my daughter diagnosed, even after all the heart tests!


louiseelcross profile image

louiseelcross 4 months ago from UK

Thanks for this hub which is informative and explains well the condition of costochondritis. I have fibromyalgia, lupus and other conditions and suffer from this condition. I agree that all chest pain need investigation to rule out anything more serious. I did not bother with my gp when I was having chest pain because I have had conditions a long time but last year i mentioned the pain and ended up having coronary angiogram. Better to be safe than sorry and get checked. Thanks again and I hope you and your daughter are well.

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