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Chest Pain | RemedyConnect

Is this your symptom?

  • Uncomfortable pressure, fullness, squeezing, or other pain in the chest
  • This includes the area from the collar-bone to the bottom of the rib cage

Some Basics…

  • Not all chest pain is serious. But it is safer to assume that chest pain is serious until seen by a doctor.
  • Serious causes of chest pain include angina, aortic dissection (tear in aorta), myocardial infarction (heart attack), pericarditis (inflammation of heart), pneumonia, and pneumothorax (collapsed lung).
  • Less serious cause of chest pain include costochondritis (arthritis of ribs), gastro-esophageal reflux (GERD or acid reflux), and muscle strain.
  • Pain felt in the chest can come from things besides the heart. The ribs, spine, lungs, and other organs in the upper abdomen can also cause chest pain.

Pain Scale

  • None: no pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: the pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: the pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: the pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

What Are the Symptoms of a Heart Attack?

  • Chest pain or discomfort: this is normally felt in the center of the chest. It may feel like pressure, squeezing, or heaviness. It lasts for more than a few minutes.
  • Upper body pain or discomfort: felt in the upper arms, jaw, neck, or back.
  • Shortness of breath
  • Other symptoms: these can include sweating more than normal, nausea, and feeling lightheaded.

If you think you are having a heart attack, call 911 (an ambulance) right away!

When to Call for Chest Pain

Call 911 Now

  • Passed out (fainted)
  • Very weak (can’t stand)
  • Sweat on or dripping down face
  • Severe trouble breathing (struggling for each breath or can’t speak)
  • Lips or face are blue
  • Severe chest pain
  • Chest pain lasting more than 5 minutes and any of these:
    • Pain is crushing, pressure-like, or heavy
    • History of heart disease (angina, heart attack, bypass surgery, angioplasty)
    • More than 50 years old
    • More than 30 years old and have one or more cardiac risk factors (high blood pressure, diabetes, high cholesterol, obesity, smoker, or strong family history of heart disease)
  • Took nitroglycerin and chest pain did not go away
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Fever
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Rash or blisters in same area as pain
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Chest pain that comes and goes for a few seconds each time, and lasts more than 3 days
  • Chest pain only when coughing, and lasts more than 3 days
  • You have other questions or concerns

Self Care at Home

  • Chest pains come and go for a few seconds each time
  • Mild chest pain only when coughing

Care Advice

Mild Chest Pain

  1. What You Should Know:
    • Not all chest pain is serious. But it is safer to assume that your chest pain is serious until you see a doctor.
    • Pain felt in the chest can come from things besides the heart. The ribs, spine, lungs, and other organs in the upper abdomen can also cause chest pain.
    • You can treat mild chest pain at home.
    • Here is some care advice that should help.
  2. Fleeting Chest Pain: These pains last only a few seconds and then go away. They are usually not serious. They may be from pinched muscles or nerves in your chest wall.

  3. Chest Pain Only When Coughing: Pain comes from the chest wall and airway irritation. This pain is most often not serious.

  4. Cough Medicines:
    • Over-the-Counter (OTC) Cough Syrups: Some people find that cough syrups help decrease coughing. Dextromethorphan is the most common cough suppressant in OTC cough syrups. Often the letters “DM” appear in the name.
    • OTC Cough Drops: Cough drops can help a lot. They work best for mild coughs. They soothe the tickling feeling in the back of the throat. Cough drops are easy to carry with you.
    • Home Remedy – Hard Candy: Hard candy works just as well as OTC cough drops. People who have diabetes should use sugar-free candy.
    • Home Remedy – Honey: Honey has been shown to help decrease coughing at night. The adult dose is 2 teaspoons (10 mL) at bedtime.
  5. What to Expect: These mild chest pains most often go away within 3 days.

  6. Call Your Doctor If:
    • Severe chest pain
    • Constant chest pain lasts more than 5 minutes
    • Trouble breathing occurs
    • Fever occurs
    • You think you need to be seen
    • You get worse

Internet Resources

  1. Heart Attack Symptoms and Warning Signs:
    • The American Heart Association has helpful information about heart attack, stroke, and other diseases.
    • You can find this online at: Heart Attack and Stroke Symptoms
  2. Women and Heart Disease:

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed:11/16/2021 1:00:40 AM
Last Updated:10/21/2021 1:00:42 AM

Copyright 2021 Amazon.com, Inc., or its affiliates.

What is Tietze’s Syndrome?

Definition

Named after Alexander Tietze, a German surgeon (1864-1927), Tietze’s syndrome is an inflammation of the costochondral (pertaining to the ribs) cartilages. It is characterized by swelling of one or more costal cartilages causing pain that may radiate to the neck, shoulder, or arm and mimic the pain of coronary artery disease.

Description

The term costochondritis is often used interchangeably with Tietze’s syndrome, but some restrict the former term to pain of the costochondral articulations without swelling.

Rheumatoid arthritis, ankylosing spondylitis, or Reiter’s syndrome may involve costochondral joints but are distinguished easily by their other clinical features.

Causes

The cause is unknown. The syndrome usually affects older children and young adults. It occurs more often in women than men.

Symptoms

Pain, tenderness, and spindle-shaped swelling occur in one or more of the 4 upper ribs. Most patients have only one joint involved, usually the second or third costochondral joint. The tenderness and swelling are localized.

The pain may have a sudden or gradual onset, and may be mild or severe, dull or sharp in nature. Sudden coughing or deep breathing accentuates the pain. The pain typically diminishes after a few weeks or months, but the swelling may persist.

The pain from costochondritis may be most noticeable when an individual is lying in bed at night. It is important to find a suitable lying position in order to reduce the degree of discomfort. It may be useful to use local heat as much as possible providing this does not aggravate the condition.

Diagnosis

The medical history and physical examination are usually sufficient for diagnosis.

Treatment

Treatment consists of local heat, analgesics, anti-inflammatory drugs, or local steroid injections. These usually relieve symptoms. Most often the pain subsides after a few weeks or months but swelling may remain for a longer period of time.

What Know About Chest Pain in Athletes – Cleveland Clinic

You’re young. You’re an athlete. So why does your chest hurt? After all, don’t heart problems strike older, less active people?

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Most of the time, that’s true. But no one is immune to heart problems, and symptoms are ignored at our peril.

You might be surprised to learn that chest pain is actually more common in athletes than it is in sedentary people. “Luckily, in young athletes, it typically isn’t a sign of heart trouble,” says sports cardiologist Tamanna Singh, MD. A medical evaluation can help you be sure.

What are the common causes of chest pain in young athletes?

If heart problems are ruled out, determining the exact cause of your chest pains can often be tricky. Check out these common causes of chest pains in young athletes — and learn what you should do if and when pain strikes.

Chest pain can be caused by trauma and inflammation

Sports can cause a lot of wear and tear on the body, and sometimes you can feel it in your chest. Athletes such as boxers, football players and lacrosse players often receive hard hits to their chests, which can bruise or fracture their ribs and cause intense pain.

Injury to the chest as well as constant, repetitive movement with intense training can also cause costochondritis, an inflammation of the cartilage that connects the ribs to the breastbone. It’s common in rowers, competitive weightlifters, tennis players and other athletes.

Athletes also may experience Tietze’s syndrome, an inflammatory disorder that affects the chest wall cartilage. And we have all experienced “stitches.” Most common when athletes start a training program, these are usually just muscle spasms.

Precordial catch syndrome causes sharp localized pains that strike during deep breathing, most often in young adults. While the condition is benign, the cause is unclear.

Look for increased heart rate, blood pressure & breathing

Athletes are often high achievers, competitive and motivated. “However, anxiety and even panic disorders and depression are not uncommon in young athletes,” says Dr. Singh. These conditions can result in spikes in heart rate or blood pressure as well as hyperventilation (rapid deep breathing), which can contribute to chest pains.

Stimulants such as caffeine, which are found in many energy drinks, can also speed up the heart, increase blood pressure and contribute to the problem.

Do you have gastrointestinal problems?

Athletes are at increased risk of gastrointestinal (GI) issues that cause chest pains. This can be related to the way you eat, what you eat and how you exercise. “For instance, athletes often put themselves through periods of fasting and feasting, which can cause stomach upset,” says Dr. Singh.

What’s more, gastroesophageal reflux disease (GERD, or heartburn) is common among athletes and is easy to mistake for heart pains (hence the more common term for GERD, “heartburn”). That’s because when you’re training, food moves more slowly from your stomach into your intestines. In response to training, the small muscular band (sphincter) around the bottom of your esophagus can relax, allowing food and acid in your stomach to rise into your esophagus and cause a burning sensation. Also, tensing your abdominal muscles during exercise increases the pressure in your stomach, thereby forcing your stomach contents up into your esophagus.

“Medications you may take for pain such as nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen, etc.) can irritate the lining of the stomach, also contributing to GI upset and chest pains,” Dr. Singh adds.

Lung problems can cause chest pain, too

When chest pain strikes during or immediately after exercise, the most common cause is a spasm of the lungs’ small airways. Called exercise-induced bronchospasm (EIB), it can cause sharp chest pains and make breathing difficult. This can often be worse at certain times of the year or when exercising in certain environments.

You may need to visit a pulmonologist for adequate testing to determine if EIB is the root of your chest pain. The good news is that treatment often results in improved athletic performance.

Rare, but more serious lung issues include pneumothorax, when air leaks into the space between your lungs and your chest wall, and pulmonary embolism, blood clots in one or more of the lungs’ arteries, which can occur after orthopaedic surgery or prolonged periods of rest after an injury.

In athletes who train or compete outside, exposure to the elements can increase the risk of viral and bacterial lung infections, which can result in either pneumonia or pleurisy, inflammation of the tissues that line the lungs and chest cavity. “The inflammation feels like a very sharp pain that is most severe when you breathe in,” Dr. Singh notes.

But what if it

is heart-related?

In athletes 35 and older, the most common cardiac cause of chest pain is angina. Angina is caused by reduced blood flow to the heart muscle as a result of coronary artery disease. The pain is often experienced with exercise and eases up with rest.

In younger athletes, cardiac chest pains are most commonly related to congenital heart defects, meaning you were born with the problem. These include:

  • Hypertrophic cardiomyopathy, an excessive thickening of the heart muscle — which is the leading cause of sudden cardiac death in young athletes.
  • Abnormal locations of the coronary arteries.
  • Congenital valvular issues.

However, not all heart conditions that cause chest pains in athletes exist at birth. Myocarditis, an inflammation in the heart’s muscle, and pericarditis, inflammation of the membrane that surrounds the heart, are often caused by a virus and can be exacerbated during exercise. With respect to COVID-19, current athlete studies suggest that the rate of incidence of myocarditis is extremely low.

What to do when chest pain strikes

“If you feel a pain in your chest, don’t try to just push through it,” Dr. Singh says. Stop exercise immediately, let your trainer know what’s going on and recognize these signs:

  • Signs it’s an emergency: If there’s no obvious cause for the pain, it doesn’t resolve itself quickly, it’s associated with fainting, lightheadedness or an irregular heartbeat or you have a family history of heart disease or sudden cardiac death in a young family member, you should consider visiting the emergency room immediately.
  • Signs you need a check-up: Even if the pain lets up, you should make an appointment with a doctor experienced in treating young athletes. They will discuss your symptoms with you and evaluate your heart, lung and gastrointestinal health. If the cause of the pain is still not clear, your doctor may refer you to a sports cardiologist for further evaluation.

Heart problems contribute to only about 5% of chest pains in young athletes, but these are the ones no one wants to miss. Athlete or not, chest pains are always cause for concern and deserve prompt medical attention.­­­

Costochondritis Clinical Presentation: History, Physical, Causes

Author

Lynn K Flowers, MD, MHA, ABAARM, FACEP Physician Partner, ApolloMD; Chief Medical Officer, Flowers Medical Group

Lynn K Flowers, MD, MHA, ABAARM, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Gino A Farina, MD, FACEP, FAAEM Professor of Emergency Medicine, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center

Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Program Director, Emergency Medicine, Einstein Medical Center Montgomery

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

William K Chiang, MD Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center

William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chest Wall Pain, Costochondritis (Child)

Your child’s ribs are joined to the breastbone (sternum). This is the long flat bone in front of the chest. If these joints or the cartilage around the ribs become inflamed, it is called costochondritis. This is a common condition in preteens. Costochondritis causes tenderness on the sides of the breastbone. Your child may have mild swelling and sharp pain with breathing or coughing. Costochondritis often follows a viral illness that causes the child to cough a lot. It can also be linked to carrying a heavy school bag. It may also follow an injury, such as a fall or car accident.

Costochondritis pain may last for weeks, but eventually goes away on its own. The usual treatment is to take ibuprofen for 1 to 2 weeks as instructed on the label to ease discomfort. Ibuprofen is an anti-inflammatory medicine and is available over the counter. Your child may also need to take medicine to stop a cough. These are also available over the counter. Ask your healthcare provider to recommend specific medicines if you are not sure what to give your child.

Home care

Follow the healthcare provider’s instructions for giving medicines to your child. Don’t give any medicines that the provider has not approved.

  • Allow your child to rest as needed. Give pain medicine before an activity or before sleeping at night.
  • Put a covered heating pad or warm cloth on the area for 20 minutes. Do this 4 times a day. This may ease pain and swelling. You can also alternate the heat with cold. You can make a cold pack by wrapping a bag of chipped ice or frozen vegetables in a thin towel.
  • Have your child hold a pillow against his or her chest to ease pain when coughing.
  • Talk with your child about how he or she is feeling and what things help ease pain. Talk with your child’s provider if prescribed medicines don’t relieve the pain.
  • Ask the provider about exercises to stretch the chest muscles and ease pain. Exercises should not be done if they cause your child any pain.


Follow-up care

Follow up with your child’s healthcare provider, or as advised.


Special note to parents

Your child should not play sports until his or her healthcare provider says it’s OK.


When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children below)
  • Pain doesn’t get better or gets worse even with medicine
  • Change in the type of pain or pain gets worse
  • Chest pain does not get better in 7 days

 

Call 911

This is the fastest and safest way to get to the emergency department. The paramedics can also start treatment on the way to the hospital.

Call 911, or get medical care right away if any of these occur:

  • Trouble breathing, shortness of breath, or fast breathing
  • Your child acts very ill, or is too weak to stand


Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Baby under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.
  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.


© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Costochondritis // Middlesex Health

Overview

Costochondritis (kos-toe-kon-DRY-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

Costochondritis is sometimes known as chest wall pain, costosternal syndrome or costosternal chondrodynia. Sometimes, swelling accompanies the pain (Tietze syndrome).

Costochondritis usually has no apparent cause. Treatment focuses on easing your pain while you wait for the condition to improve on its own, which can take several weeks or longer.

Costochondritis usually goes away on its own, although it might last for several weeks or longer. Treatment focuses on pain relief.

Costochondritis most commonly affects the upper ribs on the left-hand side of your body. Pain is often worst where the rib cartilage attaches to the breastbone (sternum), but it can also occur where the cartilage attaches to the rib.

Symptoms

The pain associated with costochondritis usually:

  • Occurs on the left side of your breastbone
  • Is sharp, aching or pressure-like
  • Affects more than one rib
  • Worsens when you take a deep breath or cough

When to see a doctor

If you have chest pain, you should seek emergency medical attention to rule out life-threatening causes such as a heart attack.

Causes

Costochondritis usually has no clear cause. Occasionally, however, costochondritis may be caused by:

  • Injury. A blow to the chest is one example.
  • Physical strain. Heavy lifting, strenuous exercise and severe coughing have been linked to costochondritis.
  • Arthritis. Costochondritis might be linked to specific problems, such as osteoarthritis, rheumatoid arthritis or ankylosing spondylitis.
  • Joint infection. Viruses, bacteria and fungi — such as tuberculosis, syphilis and aspergillosis — can infect the rib joint.
  • Tumors. Noncancerous and cancerous tumors can cause costochondritis. Cancer might travel to the joint from another part of the body, such as the breast, thyroid or lung.

Risk factors

Costochondritis occurs most often in women and in people older than 40.

Tietze syndrome usually occurs in teenagers and young adults, and with equal frequency in men and women.

Diagnosis

During the physical exam, your doctor will feel along your breastbone for areas of tenderness or swelling. The doctor may also move your rib cage or your arms in certain ways to try to trigger your symptoms.

The pain of costochondritis can be very similar to the pain associated with heart disease, lung disease, gastrointestinal problems and osteoarthritis. While there is no laboratory or imaging test to confirm a diagnosis of costochondritis, your doctor might order certain tests — such as an electrocardiograph, X-ray, CT or MRI — to rule out other conditions.

Treatment

Costochondritis usually goes away on its own, although it might last for several weeks or longer. Treatment focuses on pain relief.

Medications

Your doctor might recommend:

  • Nonsteroidal anti-inflammatory drugs. Although certain medications, such as ibuprofen (Motrin IB) or naproxen sodium (Aleve) are available over the counter, your doctor might prescribe stronger varieties of these nonsteroidal anti-inflammatory medications. Side effects might include damage to your stomach lining and kidneys.
  • Narcotics. If your pain is severe, your doctor might prescribe medications containing codeine, such as hydrocodone/acetaminophen (Vicodin, Norco) or oxycodone/acetaminophen (Tylox, Roxicet, Percocet). Narcotics can be habit-forming.
  • Antidepressants. Tricyclic antidepressants, such as amitriptyline, are often used to control chronic pain — especially if it’s keeping you awake at night.
  • Anti-seizure drugs. The epilepsy medication gabapentin (Neurontin) also has proved successful in controlling chronic pain.

Therapy

Physical therapy treatments might include:

  • Stretching exercises. Gentle stretching exercises for the chest muscles may be helpful.
  • Nerve stimulation. In a procedure called transcutaneous electrical nerve stimulation (TENS), a device sends a weak electrical current via adhesive patches on the skin near the area of pain. The current might interrupt or mask pain signals, preventing them from reaching your brain.

Surgical and other procedures

If conservative measures don’t work, your doctor might suggest injecting numbing medication and a corticosteroid directly into the painful joint.

Lifestyle and home remedies

It can be frustrating to know that there’s little your doctor can do to treat your costochondritis. But self-care measures might make you feel more comfortable. They include:

  • Over-the-counter nonsteroidal anti-inflammatory drugs pain relievers. Ask your doctor about using ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others).
  • Heat or ice. Try placing hot compresses or a heating pad on the painful area several times a day. Keep the heat on a low setting. Ice also might be helpful.
  • Rest. Avoid activities that make your pain worse.

Preparing for an appointment

You may be referred to a doctor who specializes in disorders of the joints (rheumatologist).

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
  • Write down your key medical information, including other conditions and any history of injury to the painful joint.
  • Write down key personal information, including any major changes or stressors in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.
  • Write down questions to ask your doctor.

Questions to ask your doctor

  • What’s the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What self-care steps are likely to help improve my symptoms?
  • Do I need to restrict any activities?
  • What new signs or symptoms should I watch for at home?
  • How soon do you expect my symptoms will resolve?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked:

  • When did you first begin experiencing these symptoms? Have they worsened over time?
  • Where is your pain located?
  • Does exercise or physical exertion make your symptoms worse?
  • Does anything else seem to make your pain worse or better?
  • Are you having any difficulty breathing?
  • Have you had any recent respiratory infections?
  • Have you had any recent injuries to your chest?
  • Have you been diagnosed with any other medical conditions?
  • Have you recently experienced a significant amount of stress or change?
  • Are you aware of any history of heart problems in your family?

©1998-2021 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. Terms of Use

Costochondritis | Beacon Health System

Overview

Costochondritis (kos-toe-kon-DRY-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

Costochondritis is sometimes known as chest wall pain, costosternal syndrome or costosternal chondrodynia. Sometimes, swelling accompanies the pain (Tietze syndrome).

Costochondritis usually has no apparent cause. Treatment focuses on easing your pain while you wait for the condition to improve on its own, which can take several weeks or longer.

Costochondritis usually goes away on its own, although it might last for several weeks or longer. Treatment focuses on pain relief.

Symptoms

The pain associated with costochondritis usually:

  • Occurs on the left side of your breastbone
  • Is sharp, aching or pressure-like
  • Affects more than one rib
  • Worsens when you take a deep breath or cough

When to see a doctor

If you have chest pain, you should seek emergency medical attention to rule out life-threatening causes such as a heart attack.

Causes

Costochondritis usually has no clear cause. Occasionally, however, costochondritis may be caused by:

  • Injury. A blow to the chest is one example.
  • Physical strain. Heavy lifting, strenuous exercise and severe coughing have been linked to costochondritis.
  • Arthritis. Costochondritis might be linked to specific problems, such as osteoarthritis, rheumatoid arthritis or ankylosing spondylitis.
  • Joint infection. Viruses, bacteria and fungi — such as tuberculosis, syphilis and aspergillosis — can infect the rib joint.
  • Tumors. Noncancerous and cancerous tumors can cause costochondritis. Cancer might travel to the joint from another part of the body, such as the breast, thyroid or lung.

Risk factors

Costochondritis occurs most often in women and in people older than 40.

Tietze syndrome usually occurs in teenagers and young adults, and with equal frequency in men and women.

Diagnosis

During the physical exam, your doctor will feel along your breastbone for areas of tenderness or swelling. The doctor may also move your rib cage or your arms in certain ways to try to trigger your symptoms.

The pain of costochondritis can be very similar to the pain associated with heart disease, lung disease, gastrointestinal problems and osteoarthritis. While there is no laboratory or imaging test to confirm a diagnosis of costochondritis, your doctor might order certain tests — such as an electrocardiograph, X-ray, CT or MRI — to rule out other conditions.

Treatment

Costochondritis usually goes away on its own, although it might last for several weeks or longer. Treatment focuses on pain relief.

Medications

Your doctor might recommend:

  • Nonsteroidal anti-inflammatory drugs. Although certain medications, such as ibuprofen (Motrin IB) or naproxen sodium (Aleve) are available over the counter, your doctor might prescribe stronger varieties of these nonsteroidal anti-inflammatory medications. Side effects might include damage to your stomach lining and kidneys.
  • Narcotics. If your pain is severe, your doctor might prescribe medications containing codeine, such as hydrocodone/acetaminophen (Vicodin, Norco) or oxycodone/acetaminophen (Tylox, Roxicet, Percocet). Narcotics can be habit-forming.
  • Antidepressants. Tricyclic antidepressants, such as amitriptyline, are often used to control chronic pain — especially if it’s keeping you awake at night.
  • Anti-seizure drugs. The epilepsy medication gabapentin (Neurontin) also has proved successful in controlling chronic pain.

Therapy

Physical therapy treatments might include:

  • Stretching exercises. Gentle stretching exercises for the chest muscles may be helpful.
  • Nerve stimulation. In a procedure called transcutaneous electrical nerve stimulation (TENS), a device sends a weak electrical current via adhesive patches on the skin near the area of pain. The current might interrupt or mask pain signals, preventing them from reaching your brain.

Surgical and other procedures

If conservative measures don’t work, your doctor might suggest injecting numbing medication and a corticosteroid directly into the painful joint.

Lifestyle and home remedies

It can be frustrating to know that there’s little your doctor can do to treat your costochondritis. But self-care measures might make you feel more comfortable. They include:

  • Over-the-counter nonsteroidal anti-inflammatory drugs pain relievers. Ask your doctor about using ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others).
  • Heat or ice. Try placing hot compresses or a heating pad on the painful area several times a day. Keep the heat on a low setting. Ice also might be helpful.
  • Rest. Avoid activities that make your pain worse.

Preparing for an appointment

You may be referred to a doctor who specializes in disorders of the joints (rheumatologist).

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
  • Write down your key medical information, including other conditions and any history of injury to the painful joint.
  • Write down key personal information, including any major changes or stressors in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.
  • Write down questions to ask your doctor.

Questions to ask your doctor

  • What’s the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What self-care steps are likely to help improve my symptoms?
  • Do I need to restrict any activities?
  • What new signs or symptoms should I watch for at home?
  • How soon do you expect my symptoms will resolve?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked:

  • When did you first begin experiencing these symptoms? Have they worsened over time?
  • Where is your pain located?
  • Does exercise or physical exertion make your symptoms worse?
  • Does anything else seem to make your pain worse or better?
  • Are you having any difficulty breathing?
  • Have you had any recent respiratory infections?
  • Have you had any recent injuries to your chest?
  • Have you been diagnosed with any other medical conditions?
  • Have you recently experienced a significant amount of stress or change?
  • Are you aware of any history of heart problems in your family?

Last Updated: April 22nd, 2020

90,000 What are the different types of Costochondritis treatment?

Costochondritis treatment primarily consists of anti-inflammatory drugs and pain relievers, many of which can be purchased without a prescription. Often the pain from this condition goes away without additional treatment, and so sometimes rest is all that is prescribed. Some doctors may also prescribe a muscle relaxant to treat costochondritis, or may simply recommend placing a heating pad on your chest if you have pain.

The type of costochondritis treatment may also depend on what is causing the condition.The chest pain that occurs with costochondritis is associated with inflammation in the costochondral joints located in the chest. Although not considered serious or life-threatening, the condition is very painful and doctors are not sure what is causing it, although some form of arthritis is often suspected. In some cases, costochondritis can be caused by an upper respiratory infection or injury. If symptoms are the result of any of these, treatment for costochondritis will also include treatment for the infection or injury.

Most doctors suggest ibuprofen, which is an over-the-counter anti-inflammatory pain reliever. Experts advise that this should only be used as a medicine, however, after testing has been done to determine if costochondritis is the cause of chest pain or not. Health experts do not recommend trying to self-diagnose this type of pain, and they also do not recommend a specific treatment for costochondritis until a thorough examination is performed.

Before deciding on a treatment for costochondritis, doctors examine the chest by pressing on and around the costochondral joints. If a patient reports pain or soreness in this area during examination, the doctor will usually diagnose the pain as caused by this condition. Usually, only after an examination are offered various treatments for this condition.

If there is a suspicion of another medical condition, such as a lung infection or recent injury, your doctor will likely do additional tests, which may include a chest x-ray.When pain is related to one of these conditions, treatment for costochondritis also includes treating the underlying cause. In some cases, doctors recommend applying a hot or cold compress to the chest to relieve pain.

In most cases, treatment with costochondritis is very minimal. Many people believe that pain and inflammation will go away naturally after a few days of rest. For some, symptoms appear only during vigorous exercise and disappear soon after exercise is stopped.In these cases, pain relievers to treat costochondritis may help those who want to keep exercising despite the pain.

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90,000 Chest pain: diagnosis and treatment

Symptoms of chest pain

May indicate the presence of dangerous diseases.

  • Sudden sharp stabbing chest pain
  • Psychogenic chest pain
  • Pain in skin diseases
  • Pain of muscle origin
  • Pain with lesions of the spine
  • Pain in diseases of the lungs
  • Pain in cardiovascular diseases
  • Pain with damage to the esophagus

Diseases with chest pain

Most children have ever complained of chest pain.It is necessary to find out the exact place of localization of pain, since the child often calls the epigastric region of the abdomen the breast. The following details are important: how movements affect the nature of pain, whether they occur with muscle tension after eating, whether they appear during physical work or during sleep, whether the child suffers from bronchial asthma.
Sudden, stabbing chest pain: This condition is characterized by cramping pain in the lower chest, usually on one side or in the upper abdomen.Typically occurs after eating during physical exertion. The cause of this pain is tension in the ligaments of the peritoneum (the lining that covers the abdominal cavity) that are connected to the diaphragm.
Help: Calm the child down, let him rest. After a while, the pain should subside spontaneously.
Psychogenic chest pain: If an adult family member constantly complains of chest pains, the child may start to imitate them. This kind of pain does not occur when the child is sleeping or playing.
Help: Try to distract your child by talking or playing.

Chest pain in skin diseases

Skin pain: Chest pain can occur with shingles. In this case, you may notice a rash on the skin in the form of grouped red bumps or blisters. In addition, there is an increase in body temperature and an increase in lymph nodes.
Help: since shingles is an infectious disease, it is better to call a doctor at home and not take the child to the clinic, where he can infect other children.
Pain of muscle origin: A common cause of complaints of chest pain in children is bruising or viral myalgia (muscle inflammation caused by a viral infection). Pain usually occurs unexpectedly and has a clear localization. Muscles in the affected area are painful to touch. There are no other painful symptoms.
Help: helps by applying heat (heating pad, woolen cloth) to the sore spot. For severe pain, you can give a crushed tablet of aspirin or panadol. Doses are prescribed by the doctor after examination.

Chest pain with spinal involvement

Pain with damage to the spine: disease of the cartilaginous tissue of the ribs (costochondritis), damage to the processes of the vertebrae in trauma, tuberculosis or rheumatoid arthritis leads to pinching of the nerve and pain in the chest.
Help: To eliminate the cause of the pain, the underlying disease must be treated.
Pain in lung diseases: Inflammation of the lungs, complicated by inflammation of the pleura (the membrane lining the chest cavity), causes severe, dagger pains that intensify with vigorous breathing and radiate to the shoulder.
Help: Inflammation of the pleura of an infectious nature is more common in severe pneumonia. The child needs urgent hospitalization.

Chest pain in cardiovascular diseases

Pain in cardiovascular diseases: in rheumatism, tuberculosis, after acute respiratory infections, pericarditis (inflammation of the membrane covering the heart) or myocarditis (inflammation of the muscle tissue of the heart) may develop. The pain is usually dull, aching without clear localization, and can radiate to the shoulder or neck.It increases with swallowing and vigorous breathing. At the same time, murmurs synchronous with the beats of the heart are heard in the heart.
Help: The child must be consulted with a doctor. When the diagnosis is confirmed, hospitalization is required.

Chest pain with damage to the esophagus

Pain in the esophagus: Pain in the sternum can be caused by inflammation of the esophagus (esophagitis) if the child has swallowed a substance that irritates the mucous membrane.Other causes of pain are a foreign body in the esophagus (for example, a fish bone), hiatal hernia, and esophageal ulcer. The pain is worse when swallowing, lying down or bending forward. In addition, the child may have difficulty swallowing, bloody vomiting, black stools, or excessive salivation.
Help: The child needs an endoscopic examination of the esophagus, which can only be done in a clinic or hospital. If the symptoms are threatening, for example, sharp pain when swallowing, bloody vomiting, call an ambulance.

90,000 Pain when coughing and sneezing, causes and treatment

Treatment of pain when coughing and sneezing

In case of chest osteochondrosis, the course of treatment is aimed at relieving severe chest pain and reducing inflammation. For this purpose, non-steroidal anti-inflammatory drugs and pain relievers are used. The patient is shown bed rest for several days. Muscle relaxants are indicated to eliminate muscle spasm. When the pain syndrome was stopped, it is useful to undergo a course of physiotherapy, massage and exercise therapy.Manual therapy will help to improve blood flow in the affected area and restore the functioning of the spine.

To eliminate pain when coughing, it is effective to take antispasmodics and analgesics. The patient is advised to correct body weight, adhere to a diet and quit smoking. If the discomfort in the chest when sneezing is caused by a muscle strain, then a warming ointment should be applied to the painful areas. It relieves inflammation and swelling. Also, a cough with pain in the chest causes colds, so bronchodilators, syrups and cough tablets should be taken to eliminate it.In some cases, antihistamines and expectorants are required.

If the pain syndrome when coughing is caused by intercostal neuralgia, then the course of treatment includes special anesthetic ointments, transdermal patches, anti-inflammatory gels to improve blood circulation and reduce pain. Iodine can be used to relieve swelling. In severe cases, doctors prescribe antidepressants, non-steroidal anti-inflammatory drugs, muscle relaxants, anticonvulsants, and compresses of Dimexide with novocaine.With intercostal neuralgia at the subacute stage, microwave therapy and darsonvalization are used. They improve blood circulation in the affected areas, help relieve pain and muscle spasms. In the acute stage of the disease, it is effective to resort to such procedures as ultraviolet radiation and electrophoresis. Reflexotherapy, hirudotherapy, massage and thermopuncture have proven themselves well in the treatment of neuralgia.

For the treatment of pain when coughing and sneezing in the network of CMR clinics, the following methods are used:

Assessment of Pleurisy – Differential Diagnosis of Symptoms

Pleurisy is defined as inflammation of the pleura.The pleural space is a thin fluid-filled space between the lungs and the chest cavity that allows the lungs to rub smoothly during breathing. It is lined with two layers of pleura: visceral (covering the lungs) and parietal (covering the chest). Pain receptors are located on the parietal pleura. Irritation and inflammation of the pleura is manifested by symptoms of a sharp tingling sensation, fleeting pain in the chest, which is aggravated by deep breathing, coughing, sneezing or Valsalva breakdown (forced exhalation with closed airways) and Müller’s maneuvers (inverse to the Valsalva maneuver).

It is important to exclude potentially life-threatening conditions such as pulmonary embolism, acute coronary syndrome, aortic dissection, and pneumothorax during assessment. You should also consider the possibility of pneumonia. Although there is no cause for pleurisy, conditions such as pericarditis, perforation of an internal organ, and costochondritis should be considered in the differential diagnosis when patients experience chest pain that is pleuritic in nature.

Pathophysiology

The pleural space is a potential space that can be filled with a variety of substances, including transudate, exudate, pus, blood, air, or lymph.The pleural lining consists of a single layer of mesothelial cells supported by connective tissue. This layer not only acts as a mechanical shell, but also plays a biological role. It regulates the diffusion of substances into the pleural space and plays an integral role in inflammatory responses to stimuli such as infection, injury, or the entry of foreign substances such as air, blood, or asbestos. Mesothelial cells recognize invasion of the pleural space and initiate cell recruitment through the coordinated expression of cytokines, chemokines and vascular adhesion molecules.[1] Antony VB. Immunological mechanisms in pleural disease. Eur Respir J. 2003 Mar; 21 (3): 539-44.
http://erj.ersjournals.com/content/21/3/539.full

http://www.ncbi.nlm.nih.gov/pubmed/12662014?tool=bestpractice.com
Rapid resolution of the inflammation can allow the pleural surface to return to normal without complications. However, prolonged inflammation will distort the normal structure with fibrosis, adhesions and scars. The resolution of inflammation is directed by the initiation of apoptosis of neutrophils by mesothelial cells.[2] Anthony VB. Pleural inflammation In: Light RW, Lee YC, eds. Text book of pleural diseases. New York: Oxford University Press; 2003: 56-62.

Pleuropulmonary adhesions in the S5 lungs. Pain in the chest, when moving, lifting weights, I can not lie on my left side. How to treat, or what to do? – expert answers, online doctor consultation

Acute respiratory infections (ARI) include two groups of diseases: viral (ARVI) and bacterial.Diseases of the respiratory organs caused by the ingress of a virus into the human body account for up to 90% of all infectious pathology, and only 10% of ARI cases have a bacterial etiology. The greatest epidemic significance is the influenza A virus, which causes seasonal outbreaks of disease – influenza pandemics (an epidemic characterized by the spread of an infectious disease throughout the country). The influenza A virus demonstrates a high degree of antigenic variability, mutating every year to a new strain that our immune system is not ready to fight against.It is for this reason that every year there are outbreaks of morbidity, before which it is necessary to vaccinate.

What is the flu vaccine? This is a drug that contains killed / weakened microorganisms or their “part” (for example, hemagglutinin), capable of teaching the human body to recognize a new strain of the virus – to develop immunity to it. It takes some time to create active immunity, which is why it is necessary to be vaccinated in advance (in September – November).Vaccination in the pre-epidemic period refers to the specific prevention of influenza, but even after it, a person can get sick with ARI caused by another pathogen. That is why there is non-specific prevention that everyone should adhere to: wash your hands regularly, do not touch your face with dirty hands, wear medical masks, avoid crowded places (this is especially important for children), ventilate the room every day (especially in offices).

The ability to distinguish flu symptoms from manifestations of other acute respiratory viral infections is necessary for any person, since timely treatment (in the first 2 days of illness) will help to avoid the development of serious complications.To some extent, the symptoms of these diseases are similar, but they are more pronounced with the flu. Flu symptoms appear suddenly – literally a few hours (up to a day) after contact with a sick person. With influenza, there is a sharp jump in temperature up to 38.5 ° C and above, chills, aches / pains in all muscles, severe headaches, dizziness, dry cough with pain in the chest (whereas with ordinary ARVI, cough is accompanied by sputum production, runny nose and the temperature rarely exceeds 38 ° C).

Speaking about treatment, it is important to remember that ARVI is caused by viruses, not bacteria, so they are treated not with antibiotics, but with antiviral drugs. The treatment of ARVI and especially influenza should be approached thoroughly, after consulting a doctor, in order to avoid serious complications and a protracted course of the disease.

Costochondritis Chest pain with fibromyalgia – Chronic Fatigue Syndrome – Fibromyalgia

Do you have chest areas that are painful to the touch? A condition called costochondritis, which causes pain around the sternum and chest wall, may be to blame.It is thought to be common in people with fibromyalgia (FMS).

Costochondritis is also called noncardiac chest pain or musculoskeletal chest pain. It doesn’t involve the heart.

Because anything can hurt when you have FMS, many people don’t realize that this pain is associated with a separate condition that requires its own treatment. Since any other source of pain can worsen the symptoms of FMS, it is important for you to treat costochondritis.

Costochondritis can make you think you have heart problems, which is scary.Although costochondritis is common, you should see your doctor if you experience unexplained chest pain. You don’t want to assume that this is due to FMS and ultimately permanent heart damage, or worse.

Basics

Costochondritis is an inflammation of the cartilage that connects the ribs to the sternum. Depending on the degree of inflammation, it can range from mildly irritating to severely painful. People sometimes describe the pain as stabbing, aching, or burning.

Causes of costochondritis are unclear, but may include:

  • Chest injury, e.g. from car accident
  • Repetitive injury or overuse
  • Viral infections, especially upper respiratory tract infections

Some experts believe that FMS can cause costochondritis. Regardless of the fact that FMS makes the pain worse, it can make the cosochondritis much more painful.

Communication

An estimated 60 to 70 percent of people with FMS have symptoms very similar to costochondritis. One study listed nonspecific chest pain as the most common cause of hospitalization for people with FMS. Another lists FMS as a common cause of musculoskeletal chest pain.

Nobody is sure if this is true costochondritis or why this is happening with FMS. One hypothesis is that FMS involves inflammation of the fascia, which is a thin layer of connective tissue that runs through your entire body.If true, this may explain why costochondritis is so common in this condition.

Tender fibromyalgia points under the collarbone may also play a role. (Tender points are 18 points on the body that are used to diagnose fibromyalgia.) Myofascial pain syndrome, which is common in people with FMS, may also be the cause.

Costochondritis is usually a minor injury that heals within a few days.If symptoms don’t clear up, they could be a sign that something else is happening, such as FMS.

symptoms

Pain in the chest wall and chest is the main symptom of costochondritis. Typically, the pain will worsen with physical activity or exercise. Taking a deep breath can also cause pain because it stretches the inflamed cartilage. Sneezing and coughing can make the pain worse.

Pain can spread to both the shoulder and arms (another way to simulate a heart attack).Sometimes the pain is accompanied by redness and / or swelling in the most painful areas. When this is the case, it is called Tietze syndrome.

Diagnostics

Your doctor may diagnose costochondritis by pressing on the area where the ribs and sternum meet. If it is painful and painful, coschondritis is the most likely cause of the pain.

Doctors usually do other tests to rule out heart problems and other causes of pain before making a diagnosis.

treatment

You can treat costochondritis the same way you treat any inflammation — ice cold medications and anti-inflammatories, including Aleve (naproxen) and ibuprofen-based medications such as Advil and Motrin.

This treatment sometimes conflicts with FMS treatments, which may include other types of pain relievers and heat. If you have both, you can end up with an ice pack on your chest and a heating pad on your back at the same time.

Be sure to check with your doctor or pharmacist about any potential interactions between anti-inflammatory drugs and other medicines.

Your doctor may also recommend other treatments, including physical therapy or acupuncture.

Word from DipHealth

It’s bad enough to live with one source of chronic pain. The more you lean, the more pain you will experience and the more it can affect your life.

Fortunately, cosochondritis is relatively easy and inexpensive to treat and will not worsen PMS symptoms.

90,000 💊 Is chest pain costochondritis?

Chest pain is the main symptom Costochondritis

Pain in the chest wall around the sternum (or sternum) is the most common feature of a condition known as costochondritis.Medically speaking, the term chondritis refers to inflammation of any cartilage in the body. Costochondritis refers specifically to inflammation of the cartilage that connects the ribs to the sternum (called costal cartilage). Chest pain with costochondritis is sometimes severe.

Costochondritis usually, but not always, affects one side of the sternum. Sometimes the pain can extend to the shoulder or arm on the side involved. When costochondritis is accompanied by swelling of the areas surrounding the cartilage, the condition is called Titze’s syndrome.In Tietze syndrome, the swollen area of ​​inflamed cartilage may be tender to the touch, and the skin overlying the cartilage may be reddened.

Who Gets Costochondritis?

Costochondritis most often occurs in people between the ages of 20 and 40. In most cases, doctors do not know why the condition develops. Trauma to the chest wall can lead to costochondritis, and viral infections, especially upper respiratory tract infections, are also thought to cause costochondritis.The condition can also occur as a sign of more common inflammatory diseases such as certain forms of arthritis, fibromyalgia, and inflammatory bowel disease.

It is important to remember that any type of chest pain must be evaluated by a physician to rule out the possibility of heart or lung disease, and the diagnosis of costochondritis is made only after these more serious causes of chest pain have been ruled out.

How Can I Get Relief From Costochondritis?

If you develop costochondritis, your doctor will advise you to rest and avoid engaging in any activity that aggravates the pain.While there is no specific treatment for costochondritis, nonsteroidal anti-inflammatory drugs (or NSAIDs like ibuprofen) are often prescribed to relieve pain and inflammation. For Tietze syndrome, ice packs can help reduce swelling. In severe cases, your doctor may recommend cortisone injections or lidocaine patches (a local anesthetic).