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Costochondritis-The
Heart Attack That Wasn't
For
many years I've seen the scenario repeat itself. The
patient comes in with a panicked look on his/her face
and says, "I think I may be having a heart attack."
The
electrocardiogram is normal and the answers to my
questions don't add up to heart problems. Less than
thirty seconds on the exam table, however, yields
the diagnosis-costochondritis.
What is this strange sounding ailment? Costochondritis
is an inflammation in the cartilages where the ribs
join the breastbone. Since we have to take breaths
in and out of our lungs, there cannot be a direct
rigid attachment of the ribs to the breastbone.
Instead,
the ribs join the breastbone (known medically as the
sternum) through flexible cartilages known as costal
cartilages. But just like any cartilage, these costal
cartilages in the chest wall can get inflamed. This
is costochondritis, which literally means inflammation
of the cartilage.
The
key symptom is pain-not in the center portion of the
chest under the breastbone, which is more typical
of heart related pain-but rather pain along the edges
of the breastbone. Many patients, and even doctors,
can occasionally be thrown off as the pain can radiate
into the arms, shoulders, or across the entire chest.
Another
tip-off that this is cartilage inflammation rather
than a more serious heart ailment is the fact that
the pain increases with twisting movements of the
upper body-reaching for something (especially overhead),
taking in a very deep breath, coughing, or sneezing.
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