Chest wall pain or costochondritis, also called Tietze’s syndrome, is a condition in which inflammation occurs between the tissues that connect the rib to the sternum (breast bone). For some people, this pain can be alarming because it may feel similar to the pain caused by an oncoming heart attack.
Costochondritis is often caused by temporary inflammation of the costal cartilage found between the ribs and sternum at the costosternal joint. This often causes chest pain that simply resolves on its own, but until then, it is considered a medical emergency as symptoms may resemble that of a heart attack. Once cardiac etiologies have been ruled out, investigation for alternative causes of chest pain can begin.
Costochondritis accounts for nearly 10–30 percent of all chest pain in children, with the peak age of the condition occurring at 12–14 years of age. Adults suffering from this form of chest pain tends to be more worrisome as it could potentially be interpreted as a sign of heart problems, leading doctors to perform a battery of tests to rule it out. Costochondritis is known to affect females more than males (70 percent vs 30 percent) and also be the result of an infection or even a complication of surgery to the sternum.
There is usually no clear cause for the development of costochondritis, however, the condition may be caused by any of the following:
You should seek medical care if experiencing the following symptoms:
Pain from costochondritis may be temporary, but if it is chronic it can be quite debilitating. This pain can return during physical activity or even everyday tasks, so costochondritis can really negatively impact a person’s quality of life.
First and foremost, if pain is constant, you will want to rule out other causes, including heart problems or even pneumonia. If these are ruled out, then your doctor may test for fibromyalgia, because costochondritis is a common symptom of fibromyalgia.
In fibromyalgia, you experience pain throughout the body, fatigue and inability to rest due to pain, difficulty focusing or concentrating, feelings of depression, and headaches.
Serious cases of chest pain will usually be looked into further. A full workup including medical history and a physical exam will be done to rule out potential cardiac causes. This is often the first step in all serious cases of chest pain. It will help provide any additional clues that can be used as evidence before proceeding to additional testing. Generally, once life-threatening causes of chest pain have been ruled out and tenderness along the sternum is identified, a diagnosis of costochondritis can be made. Additional tests to rule out other conditions may include:
Blood tests: Looking for cardiac enzymes within the blood that indicates a previous episode of myocardial infarction (heart attack) has occurred.
Electrocardiogram (ECG/EKG): This test is used to measure electrical signals that are produced when the heart contracts. Electrodes are attached to the chest at various points to get an idea of how well the heart contracts and whether there are any abnormalities. This will be clearly seen on the ECG tracing.
Echocardiogram: The use of sound waves that are able to produce real-time images of the heart muscles can reveal thickened muscle tissue of the left ventricle, blood flow through the heart with each beat, and other cardiac abnormalities.
Chest X-ray: A simple imaging test that is able to provide physicians with a good approximation of heart size and health status of the lungs.
Typical treatment of costochondritis includes taking anti-inflammatory medications, physical therapy, and – in very serious cases – surgery.
Common treatments include:
Costochondritis will go away on its own, but if you notice the pain is sticking around for weeks, seek out medical attention.
Any case of chest pain should not be ignored, as it can be difficult to say for sure that it is due to serious or non-serious causes. However, using your better judgment and recognizing that your particular cause is not normal will be the first step in recovery. With the help of a medical professional, you can find the reasons behind your particular case of chest pain, helping you address potential harmful medical conditions as soon as possible.