Unbounded Medicine

I’ve been asked –and consulted- about “rare chest pain” in several times. I could notice that people is always worried about any kind of chest pain because the fear of suffer a heart attack or a pulmonary problem. Chest pain is one of the most common symptoms that require medical attention. You –as physician- should always exclude this topics (cardiac and pulmonary) in the first place. You should keep in mind that there is a disease called costochondritis (Tietze’s syndrome) once you ruled out the main fear conditions (pulmonary and cardiac).

Costochondritis is an inflammation of the costo-sternal joint (rib-sternum) or it could be an inflammation between the costo-chondral joint (rib-rib cartilage). The group mainly affected is that woman over 40s.

Etiology (causes): Direct injury to the chest, viral infections (cold / flu), idiopathic (the cause cannot be found).

Its clinical manifestations: Pain, tenderness in those joints I already mention earlier. This pain and/or tenderness get worse when you touch the involved site or move in a certain direction.
The diagnosis it’s mainly a clinical one and the physician should always exclude a heart attack and other important things.

The gold-standard of treatment is NSAIDs (non-steroid anti-inflammatory drugs like aspirin, diclofenac, naproxen, ibuprofen, acetaminophen, etc.) for one or two weeks (this disease usually lasts for this period of time). Some patients respond well to putting a local heating pad.

You have to remember that when you have chest pain, you have to look for a health care provider immediately to exclude other serious conditions.

Regards,

Jon Mikel Iñarritu, M.D.

Spanish (Español) article