People with costochondritis may say it “feels like a heart attack,” that the pain can be severe, but is there a way to tell the difference?

To find out if there’s a way for a layperson to tell the difference between costochondritis chest pain and that of angina or a heart attack, I consulted with Donna P. Denier, MD, of The Cardiology Center with the Appalachian Regional Healthcare System.

Dr. Denier explains, “Chest pain caused by costochondritis is a common mimic of cardiac chest pain. It comes from the chest wall and usually involves the joints between the ribs and the sternum in the anterior chest.” Anterior means front.

“In contrast to cardiac chest pain, this pain is more likely to be sharp in quality and worsened by movement, respiration or coughing,” says Dr. Denier.

“This pain is musculoskeletal in etiology and is similar to other types of arthritis pain.”

The medical prefix of “chond” refers to cartilage, and the suffix of “itis” means inflammation. “Costo” refers to location in this case.

Dr. Denier continues, “It is aggravated by use of the pectoral muscles of the chest, may flare up after strenuous upper body exercise or with changes in weather.”

Weightlifters with costochondritis have reported that pectoral exercises can bring on a lot of discomfort.

“On physical exam, there is often reproducible soreness to palpation directly over the joints in this area,” says Dr. Denier about costochondritis.

“This finding is helpful in establishing the diagnosis, but it is important to remember that its presence does not rule out chest pain of cardiac origin.”

In other words, if your chest area is sore to the touch, this doesn’t mean it’s costochondritis and not a cardiac problem.

In fact, by coincidence, you can have both costochondritis and a heart problem, but remember, though the symptoms can be very similar, these two conditions are unrelated.

“Relief of costochondritis pain is best achieved with anti-inflammatory drugs,” says Dr. Denier.

“In contrast to cardiac chest pain, costochondritis does not usually worsen with generalized exertion such as walking uphill.

“Costochondritis will persist throughout the day, where cardiac chest pain tends to come and go in limited episodes.

“Cardiac chest pain can radiate to the arms, jaw, neck or upper back and is often associated with other symptoms such as shortness of breath, diaphoresis and nausea.”

donna denier, md

Dr. Denier has been practicing medicine for over 15 years and is board certified by the American Board of Internal Medicine – Cardiovascular Disease.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
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