Understanding Costochondritis: Pain That Mimics a Heart Attack
It can begin with a stabbing chest pain so severe that it feels like a heart attack, prompting immediate hospitalization.
This sharp discomfort can persist for anywhere from minutes to hours, often triggered by strenuous workouts or heavy lifting, and sometimes occurs without any apparent cause.
However, if the pain does not present with other typical heart attack symptoms—such as radiating pain to the neck, jaw, or arms—there’s a chance it could be costochondritis.
Costochondritis is an inflammation of the cartilage that connects the ribs to the sternum (breastbone). While it is generally benign, the pain associated with this condition can be significant and debilitating.
Inflamed cartilage connecting the breastbone to the ribs in costochondritis.
Erin from New York City shared her experience with costochondritis, describing an episode where the pain was so intense for 14 hours that she considered going to the hospital to rule out a heart attack.
She recalled, “The pain was so bad I couldn’t sleep, I couldn’t eat, I couldn’t do anything. I had to crouch forward just to get air.”
The prevalence of costochondritis is hard to quantify since it often goes unreported or misdiagnosed. However, according to Peter Askes, a physical therapist and founder of the American Rib Pain Institute, 1 to 2 million individuals visiting emergency rooms yearly for chest pain may have costochondritis.
Furthermore, among the 62 million patients seeing doctors for chest pain, up to 18.5 million may be affected by this condition, with approximately 80% being female and many not receiving appropriate diagnosis or treatment.
Costochondritis arises from inflammation of the protective tissue (cartilage) connecting the ribs to the breastbone. This inflammation can stem from excessive physical activity, which causes pressure and pain that may radiate to the spine.
The pain may intensify with deep breaths or when pressure is applied to the area where the ribs meet the sternum. Diagnosing costochondritis can be complex, as it typically involves ruling out other serious conditions like heart attack, pneumonia, or broken ribs.
Some individuals endure pain for only a short duration, while others may face it for months. Generally, the condition resolves independently within four weeks, although recurrences can happen.
A common cause of costochondritis is strenuous exercise or heavy lifting.
A TikToker named Melissa described her costochondritis as a “horrible cycle” of radiating pain. She stated, “So you have the chest pain and it’s also in the back because your rib is always connected around.”
Several commenters echoed her experience, with one user, Kelsey Sullivan, stating her pain was so intense it felt like a heart attack. Another user mentioned undergoing similar symptoms at the age of 27 and finally seeking medical attention.
Causes of costochondritis can include heavy lifting, viral infections, coughing, or trauma to the chest. Sarah, another New Yorker, experienced costochondritis after unexpectedly carrying her 20-pound cat, Thurston.
Concerned about the severity of her symptoms, Sarah visited her doctor, where tests ruled out conditions such as blood clots. She learned that excessive inflammation in her chest likely stemmed from the strain induced by her cat’s weight.
Doctors advised Sarah to rest and take high doses of pain relief medication.
Similarly, Erin connected her costochondritis to her vigorous yoga routine, specifically with the challenging chaturanga dandasana pose, which involves lowering the body while keeping the elbows close to the sides.
Erin attributed her bout of costochondritis to her yoga practice and the advanced poses she was doing.
This pose places significant strain on the ribcage, particularly when performed incorrectly, potentially aggravating pre-existing conditions like costochondritis. Cathy Narchese, a New Jersey yoga instructor, emphasized that poor technique can lead to injury, including costochondritis.
She highlighted the importance of proper alignment and engaging supportive muscles during yoga to prevent strain and injury.
Currently, treatment options for costochondritis are limited. Medical professionals typically recommend over-the-counter pain relief, applying heat to the affected area, and resting for a few days. In some cases, physical therapy or chiropractic treatment may be beneficial.
Discussion and Expert Insights
Expert Guests
Dr. Sara Greene (Cardiologist): “It’s crucial for patients to differentiate between chest pain indicative of a heart attack and costochondritis. Patients often arrive anxious, fearing the worst. Education is key.”
Peter Askes (Physical Therapist): “Preventative care, especially in physical training, plays a major role in avoiding exacerbations of costochondritis. Proper warm-ups and listening to your body are vital.”
Cathy Narchese (Yoga Instructor): “While yoga is a wonderful tool for strength and flexibility, it’s essential to practice with awareness of body mechanics to avoid injuries.”
Join the Conversation
Have you experienced chest pain that turned out to be costochondritis? Share your story in the comments below, and let’s join in a meaningful discussion about this often-overlooked condition!