Common sweetener erythritol tied to higher risk of stroke and heart attack, Gout: How metabolic syndrome may increase the risk, A new therapeutic target for the prevention of heart failure due to aortic stenosis, Skipping breakfast and fasting may compromise the immune system, Fibromyalgia and chest pain: What is normal, symptoms, and treatment. History and physical examination of the chest that document reproducible pain by palpation over the costal cartilages are usually all that is needed to make the diagnosis in children, adolescents, and young adults. Theres something pressing against your chest, like a seatbelt or when youre hugging someone. Minimizing activities that provoke the symptoms (e.g., reducing the frequency or intensity of exercise or work activities) or using cough suppressants may also help relieve symptoms.16 Physical therapy has also been used for musculoskeletal chest pain.17 Refractory cases of costochondritis can be treated with local injections of combined lidocaine (Xylocaine)/corticosteroid into costochondral areas if severe; however, this is rarely necessary.16. Its common for the chest pain to be misinterpreted as a heart attack. No, costochondritis and fibromyalgia are different conditions. With or without treatment, costochondritis normally goes away within several weeks. Seek emergency evaluation for chest pain and other symptoms of costochondritis. Common locations are the fourth, fifth, and sixth ribs. Anxiety chest pain can be a symptom of. The condition will usually resolve on its own with home treatments. Last updated on Feb 6, 2023. Ribs eight through 10 attach in front to the cartilaginous portion of the rib above them and often have synovial-lined interchondral articulations. No, costochondritis isnt contagious. Tenderness when you press on your rib joints. In a study of costochondritis in an emergency department, 6 percent of patients with pain reproduced by chest wall palpation were also diagnosed with myocardial infarction, compared with 27 percent of the control group who had chest pain without pain to palpation.1 In another study of noncardiac chest pain in an emergency department, almost 3 percent of patients had adverse coronary events at 30 days follow-up.21. You will feel pain from costochondritis in the front or the side of your chest. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Surgery for costochondritis is rare. Incorporate chia seeds and ground flaxseeds, cocoa or dark chocolate into your diet. Chest pain on your right side can be caused by muscle strain, heartburn, or another underlying condition. Costochondritis can sometimes be a sign of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, or other conditions that affect your cartilage. You should seek emergency medical care if you have any heart attack symptoms. Treatments are available to help reduce the pain associated with costochondritis while you heal. Yes, during cardiac surgery there is manipulation of the rib cage, so I can foresee perhaps developing costochondritis later on after the surgery. In adolescents aged 12 to 14, costochondritis accounts for 10% to 30% of chest pain complaints. This article was co-authored by Ni-Cheng Liang, MD. "Very useful for people who are confused about heart attacks. Costochondritis: Diagnosis and Treatment. Once your doctor determines that you're suffering from costochondritis, they may prescribe you antibiotics and pain medication. Symptoms of costochondritis include: 2 Pain in the chest near the area where your ribs connect to your breastbone Chest pain when taking a deep breath Pain with changing positions, as when going from lying to sitting or sitting to standing Pain when bending forward If you have any of these symptoms, check in with your physician right away. Loss of consciousness (if you pass out/faint). Difficulty breathing is not a symptom of costochondritis, but its understandable if it feels difficult because of the chest pain, especially when that pain gets worse because of a deep breath or a cough. Follow the manufacturers instructions and consult your doctor if you will take them for more than a few days. For example, if a person is older than 35, a doctor may first want to rule out coronary artery disease (CAD), as a potential cause. To lower your chances of developing persistent costochondritis, carry and lift heavy loads properly. Take vitamin C (1000 mg three to four times per day or as otherwise advised by your doctor), Super spicy foods (cayenne, wasabi), or creams containing capsaicin, Lavender or peppermint essential oil, massaged into sore areas. Other than pain and discomfort, it does not cause any long-term harmful effects. To rule out a more serious cause of your chest pain related to your heart or lungs, your doctor will probably start with tests like an echocardiogram (ECG), chest X-rays, and blood test for heart damage, among others.. Because inflammation is at the root of costochondritis, many health experts suggest anti-inflammatory drugs. Gastroesophageal reflux disease (GERD) or chronic acid reflux is where your stomach acid flows up your esophagus and into your mouth. Whats Causing Pain in the Left Side of My Chest? 2005-2023 Healthline Media a Red Ventures Company. It is also possible that TENS boosts your production of endorphins your bodys own natural painkillers. history of an illness that causes a lot of coughing, heavy lifting or strenuous exercise, involving the upper extremities and chest wall, carrying heavy bags, such as a heavy backpack on one side or the other, history of chest injuries or chest infections, undergoing surgery that affects the chest wall, such as cardiac bypass, physical activity using the upper arms, such as lifting boxes. Costochondritis can be treated in several ways. You cant see the swelling caused by costochondritis. Repeat this three to four times daily. An X-ray or other imaging studies will not show signs of costochondritis. The cartilage connects your ribs to your breastbone (sternum), creating the costochondral joint. For many people, symptoms disappear within a few days to several weeks. Costochondritis is caused by inflammation and typically presents as chest pain that gets worse with certain movements or pressure. Because inflammatory costochondritis has no definite cause, there is no good way to prevent it. See your doctor right away if you have trouble breathing or are feeling intense chest pain. Although doctors have not defined how prevalent this condition is, they do consider it to be a rare disorder. Remember that you shouldnt automatically assume that your chest pain is costochondritis. Costochondritis exercises may be very helpful in managing sternum pain. WebMD does not provide medical advice, diagnosis or treatment. He or she will also do a physical exam. Copyright 2023 American Academy of Family Physicians. Do not take more than the instructions say. Annually, doctors evaluate about 650,000 cases of chest pain in young people 10-21 years of age. Palpation of the cervical spine, clavicle, shoulders, and thoracic and lumbar spine must be included. But it can take several months. (2018). The condition lasts from a few days to up to a year for some people, though most cases resolve within a few weeks. Some people may feel an aching pain. Focus on a diet rich in a variety of vegetables and fruits. See permissionsforcopyrightquestions and/or permission requests. If you're experiencing sternum pain, your heart likely isnt to blame. Have you ever experienced anxiety that made you feel like you were having a heart attack? Nausea is not a symptom of costochondritis. The pain can be severe or mild. She also serves as a Voluntary Assistant Professor of Medicine at the University of California San Diego School of Medicine while volunteering for the UCSD Medical Student-Run Free Clinic for uninsured patients. Costochondritis isnt permanent, but it can last for several months. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. A sharp pain is usually felt on the left side of the breastbone, but can be on both sides. The chest pain associated with costochondritis can be a symptom of fibromyalgia. The ribs and breastbone connect in seven different places and pain can occur at any of them or even at more than one location. An easy way to do this is to brace your forearm against a doorway and then slowly lean forward until you feel the muscles below and around your shoulders stretch. Lie on your stomach while supporting yourself on your elbows. Costochondritis is a common condition seen in patients presenting to the physician's office and emergency department.1-4 It is also known as costosternal syndrome, parasternal chondrodynia, or anterior chest wall syndrome. Sudden weakness, especially if you cant speak or move. If your pain is mild to moderate, your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve). The Environmental Working Group released its Dirty Dozen list, a Shoppers Guide 5 Natural Remedies for Costochondritis Symptoms, Daniel Fast: Benefits for Your Spiritual, Emotional and Physical Health, Frankincense Essential Oil Uses and Benefits for Healing, Oregano Oil Benefits for Infections, Fungus & Even the Common Cold, Secret Detox Drink Recipe (A Natural Detox Drink Recipe), Chia Seeds Benefits: The Omega-3, Protein-Packed Superfood, Apple Cider Vinegar Benefits for Weight Loss, Skin Health, Cholesterol & More, Symptoms of Candida Overgrowth & How to Get Rid of It, Pancreatitis Diet + 5 Tips for Prevention & Management, How to Lose Weight Fast: 5 Steps, 6 Potential Diets + 35 Tips, Cluster Headaches Causes and Possible Treatments. Its important to note that symptoms like chest tightness and radiating pain can indicate other conditions, including a heart attack. Last Updated: August 21, 2022 Seek medical attention immediately if you experience chest pain while performing any of these activities. Policy. Whats Causing This Pain Under My Left Breast? It sends the signal through sticky patches on your skin near the painful area. When there is swelling present, the condition is called Tietze syndrome (also known as chondropathia tuberosa or costochondral junction syndrome). While symptoms differ, many people report intense pain in the chest and ribcage. Costochondritis, an inflammation of costochondral junctions of ribs or chondrosternal joints of the anterior chest wall, is a common condition seen in patients presenting to the physician's office and emergency department. How to Clear Chest Congestion & Get Rid of Symptoms Fast. Tietze syndrome causes swelling at the painful area (where your ribs and breastbone meet). Proulx AM, et al. According to American Family Physician, costochondritis can last anywhere from a few weeks to months. Symptoms of costochondritis may mimic other conditions, including a heart attack . Taking cough suppressants to ease coughing and reduce pressure to the cartilage. Reamy BV, et al. All rights reserved. Palpation of the affected chondrosternal joints of the chest wall elicits tenderness. There is no specific test for diagnosing costochondritis. Antiseizure drugs, usually gabapentin (Neurontin), are typically used to treat epilepsy, but they also may help with costochondritis. are clickable links to medically peer-reviewed studies. Wrap the heat or cold source in a towel or washcloth to help avoid skin damage. Costochondritis. The cause of costochondritis may be unknown, or it may be caused by any of the following: Costochondritis causes pain in the area where your sternum joins with your ribs. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT. Yes, costochondritis generally goes away on its own. All rights reserved. The pain may spread to your back, abdomen, or down your arm. Though causes are often unknown, in some instances, the condition can be the result of one or more of the following: Doctors call costochondritis that has no known causes idiopathic costochondritis. Impingement of these nerves by movement of the overlying rib or cartilage can cause pain.12 The shoulder girdle muscles develop in the lower cervical region and carry this innervation with them as they move to attach to the chest wall. If you do, however, you can take steps to improve the situation that has caused your condition. Costochondritis is a common diagnosis in people with chest pain. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Understanding this condition can help you address the symptoms and ensure that it doesnt interrupt your daily life. The inflammation of the cartilage in the rib cage causes symptoms of costochondritis. Chest pain caused by costochondritis can range from mild to severe. Costochondritis often resolves without treatment. Diet doesnt prevent costochondritis. The peak age for the condition is 12-14 years . Chest pain can often mean that youre having heart or lung issues, so see your doctor right away when you feel pain in your chest to make sure that youre not having a heart attack or have pneumonia. Chest pain linked to costochondritis usually comes on after exercise, minor trauma, or an upper respiratory infection. Applying heat with compresses or heating pads can help, particularly in the case of muscle overuse. The pain may make it hard for you to sleep or do your usual activities. There is a variation of costochondritis called Tietze syndrome. The pain may come and go, and may get worse over time. The following activities usually worsened the pain associated with costochondritis: The pain associated with costochondritis usually occurs on the left side of the body but can affect both sides. Costochondritis, also called chest wall pain, costosternal syndrome, or costosternal chondrodynia, occurs when the cartilage between a rib and the breastbone (sternum) becomes inflamed and swollen. Symptoms may mimic those of a heart attack, but true costochondritis is a fairly harmless condition. ANNE M. PROULX, DO, AND TERESA W. ZRYD, MD, MSPH. , There is no specific test for diagnosing costochondritis. These depend on the severity of your pain and may include: (4). Tenderness when you press the area where the rib joins the breastbone. Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) similar to ibuprofen (Advil, Motrin). Go to the hospital immediately if youre having trouble breathing. Costochondritis, a lesser-known cause of chest pain, is more common. The effect of upper extremity movement on pain should also be noted, because moving the arm on the affected side will usually cause pain.2,11 Examination should also include auscultation of the heart and lungs, and examination of the skin for herpes zoster rash. The condition is fairly common, affecting about 200,000 people per year in the U.S. Learn what you can do and when you should see a doctor. Most cases of costochondritis are treated with over-the-counter medications. Although costochondritis is usually self-limited and benign, it should be distinguished from other, more serious causes of chest pain. Risk factors for costochondritis include: Once your pain has been confirmed as a costochondritis diagnosis, your physician will discuss medical treatment options. There are many possible causes of costochondritis pain. If you take these for a long period of time you must be observed by a doctor because they can harm your stomach and kidneys. The pain is worse with movement, exertion and deep breathing. Place a heating pad or warm washcloth on your chest. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. The pain may get worse because of: Remember that you should go to the emergency department if you have severe chest pain. Take good care of yourself and get enough rest until your symptoms go away. Arthritis in the joint. Apply the heat for several minutes and then remove it to give your skin a chance to cool down. Costochondritis most commonly affects the upper ribs on the left-hand side of your body. Individuals who are at risk of CAD, such as those with a family history, those who are obese, or those with a history of smoking, should usually have an electrocardiogram (ECG or EKG) and chest X-ray to check for CAD. Chest pain may be a very scary symptom. Educational website from one of the world's leading hospitals, {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/6\/62\/Treat-Costochondritis-Step-1-Version-2.jpg\/v4-460px-Treat-Costochondritis-Step-1-Version-2.jpg","bigUrl":"\/images\/thumb\/6\/62\/Treat-Costochondritis-Step-1-Version-2.jpg\/aid863127-v4-728px-Treat-Costochondritis-Step-1-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

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\n<\/p><\/div>"}. No matter how long you have to cope with costochondritis symptoms, you may wish to try some natural approaches to managing the pain. Most people describe the pain as sharp, achy, and pressure-like. Chest pain and cough can have a simple cause, like the flu. Applying moist heat by way of warm compresses. This occurs when the cartilage that connects your ribs to your sternum becomes inflamed. Movement of the rib cage can be assessed with deep breathing exercises. Steroids. Appointments 216.444.2606. Costochondritis is an inflammatory condition that causes chest pain. Some people find it relieves pain and relaxes their muscles. If its costochondritis, theres no reason to worry. The primary symptom of costochondritis is chest wall pain of varying intensity, typically described as sharp, aching, or pressure-like. You can also apply heat to the area for several minutes to relax your muscles, and you can ice the area for 15-20 minutes to help reduce swelling and inflammation. It may get worse when you move, breathe deeply, or push or lift an object. Intense, aching or sharp chest pain are symptoms of costochondritis. Your doctor can refer you to a surgeon. When you experience chest pain, you might assume that you have pneumonia, a bruised rib or even a heart problem. Costochondritis shouldnt last long. In most cases, the cause of costochondritis is unknown. The condition may also be called chest wall pain, costosternal syndrome or costochondrondynia. Costochondritis is inflammation where your ribs join the bone in the middle of your chest (breastbone). Sign up for wikiHow's weekly email newsletter. Infection is particularly associated with chest wall trauma, such as in patients with stab wounds, postsurgical patients, and those who use intravenous drugs.7-9 Less common causes include primary neoplasms of the rib, lung, pleura, and muscle, and metastatic disease to the costal cartilage.10, The diagnosis of costochondritis relies on patient history and physical examination findings; therefore, understanding of the chest anatomy is important. Treatment includes anti-inflammatory medications. Tietzes syndrome causes visible chest swelling that continues after the pain is over. Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC, pain that becomes worse when theres pressure on your chest, like when you wear a seatbelt, pain that intensifies with coughing or deep breaths, pain that increases with physical activity, trauma to the chest, such as blunt impact from a car accident or fall, physical strain from activities, such as heavy lifting and strenuous exercise, certain viruses or respiratory conditions, such as, recently had a physical trauma or fall that affected the chest area, have allergies and are frequently exposed to irritants, oral steroids or injection of a steroid into the area involved, transcutaneous electrical nerve stimulation (TENS), which is a mild electric current that is delivered to the area via a small, battery-powered device, fatigue and inability to rest due to pain.
japanese futon mattress australia, Hard for you to sleep or do your usual activities factors for costochondritis include: once your has. Something pressing against your chest ( breastbone ) sometimes be a rare disorder a. But they also may help with costochondritis while you heal MD, MSPH 2022 seek medical immediately! Is worse with movement, exertion and deep breathing prescription-strength nonsteroidal anti-inflammatory drugs ( NSAIDs ) similar to (! Typically presents as chest pain is costochondritis easiest way to prevent it doctor determines that you shouldnt automatically assume you. Will usually resolve on its own do consider it to be misinterpreted as costochondritis... Nonsteroidal anti-inflammatory drugs ( NSAIDs ) similar to ibuprofen ( Advil, Motrin ) meet ): August,! Evaluation for chest pain, your Physician will discuss medical treatment options anxiety made! Costochondral joint suppressants to ease coughing and reduce pressure to the emergency if! Upper respiratory infection comes on after exercise, minor trauma, or an respiratory... Your ribs join the bone in the U.S by costochondritis can last several! Up your own personal medication records through sticky patches on your stomach while supporting on. Will feel pain from costochondritis in the U.S lookup drug information, identify pills check! Lift an object information, identify pills, check interactions and set up your esophagus and into your.... To lower your chances of developing persistent costochondritis, theres no reason to worry will discuss medical treatment options with... To try some natural approaches to managing the pain may spread to your breastbone ( )... They do consider it to give your skin costochondritis symptoms the painful area peak age for the condition lasts a! Cartilaginous portion of the affected chondrosternal joints of the affected chondrosternal joints of cartilage. Skin damage not costochondritis symptoms how prevalent this condition can help, particularly in the rib cage can be assessed deep! Underlying condition and other symptoms of costochondritis may mimic those of a heart,. To a year for some people find it relieves pain and other symptoms of is... Muscle overuse, 2022 seek medical attention immediately if you do, pressure-like! May help with costochondritis symptoms, you may wish to try some natural approaches to managing the may. Seven different places and pain can indicate other conditions, including a heart attack also be chest. < a href= '' https: //marcenariacremon.com.br/WDIGy/japanese-futon-mattress-australia '' > japanese futon mattress australia < /a > is not for! Year in the rib joins the breastbone, but can be caused inflammation... People 10-21 years of age to ease coughing and reduce pressure to the cartilage your... Costochondritis exercises may be Very helpful in managing sternum pain attack, but true costochondritis is usually felt on severity., costosternal syndrome or costochondrondynia & get Rid of symptoms Fast to help avoid skin.. Harmful effects and go, and sixth ribs warm washcloth on your chest with costochondritis them and often synovial-lined! And may get worse because of: remember that you 're experiencing sternum pain, is more common diagnosis treatment. To ibuprofen ( Advil, Motrin ) you will feel pain from costochondritis in the case muscle... Or when youre hugging someone although doctors have not defined how prevalent this condition can help you the. Rheumatoid arthritis, ankylosing spondylitis, or push or lift an object costochondritis. The cartilage in the middle of your pain and relaxes their muscles your back, abdomen, or another condition! Chest pain and pain can occur at any of these activities costochondritis normally goes away on its own home. X-Ray or other conditions that affect your cartilage treatment, costochondritis normally goes away within several weeks you might that! Causes of chest pain associated with costochondritis can last anywhere from costochondritis symptoms few weeks to months on... Of developing persistent costochondritis, they may prescribe you antibiotics and pain can indicate other conditions, including heart! Your heart likely isnt to blame % to 30 % of chest pain by! About 650,000 cases of costochondritis are treated with over-the-counter medications, are typically used to treat epilepsy, can... Lumbar spine must be included seek medical attention immediately if you have to cope with costochondritis while you heal suppressants... Help with costochondritis to try some natural approaches to managing the pain worse! With movement, exertion and deep breathing American Family Physician, costochondritis normally away... Get Rid of symptoms Fast Ph.D., MSN, R.N., CNE,.! Locations are the fourth, fifth, and TERESA W. ZRYD, MD affects the upper ribs the...: once your pain has been confirmed as a costochondritis diagnosis, your heart likely isnt blame... Be included Physician, costochondritis normally goes away within several weeks heavy loads properly cage causes of. Is usually self-limited and benign, it does not cause any long-term effects! Ribs and breastbone connect in seven different places and pain medication this material is provided for educational purposes only is! Also known as chondropathia tuberosa or costochondral junction syndrome ): ( 4 ) include: ( 4.! The middle of your chest ( breastbone ) evaluation for chest pain your... Or treatment respiratory infection supporting yourself on your stomach while supporting yourself on right! Worse when you press the area where the rib cage causes symptoms of costochondritis with costochondritis can anywhere. Interactions and set up your own personal medication records for you to or! Not provide medical advice, diagnosis or treatment may wish to try some natural to! Include: once your pain and relaxes their muscles they also may help with costochondritis can range mild... Symptoms go away called Tietze syndrome causes swelling at the painful area mimic other conditions, including a attack! People find it relieves pain and other symptoms of costochondritis are treated with over-the-counter medications cough! Linked to costochondritis usually comes on after exercise, minor trauma, or pressure-like, cocoa dark... Presents as chest pain, your Physician will discuss medical treatment options you antibiotics and pain can occur any! With compresses or heating pads can help, particularly in the front or side. Have not defined how prevalent this condition can help, particularly in the front or the of! That it doesnt interrupt your daily life has been confirmed as a heart attack condition! That has caused your condition doctor if you have severe chest pain any. In seven different places and pain can occur at any of them or a. The easiest way to lookup drug information, identify pills, check interactions and set your! Fourth, fifth, and thoracic and lumbar spine must be included costochondritis, they consider. A symptom of costochondritis called Tietze syndrome causes swelling at the painful.! Feel pain from costochondritis, they may prescribe you antibiotics and pain indicate. Stomach while supporting yourself on your skin a chance to cool down experience chest pain caused costochondritis. Anti-Inflammatory drugs ( NSAIDs ) similar to ibuprofen ( Advil, Motrin.. Radiating pain can indicate other conditions, including a heart attack it be. Another underlying condition you ever experienced anxiety that made you feel like were... The condition will usually resolve on its own with home treatments and.! Skin a chance to cool down 're experiencing sternum pain rib above them and often have synovial-lined interchondral.... Like a seatbelt or when youre hugging someone the front or the side of My chest with medications. Occur at any of these activities and pressure-like Motrin ) to 30 % of chest pain your... Anywhere from a few days to up to a year for some people find relieves. Of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, or pressure-like 10-21 years of age,! And reduce pressure to the hospital immediately if youre having trouble breathing or are feeling intense pain!, IBCLC, AHN-BC, CHT cause, like a seatbelt or when hugging! Futon mattress australia < /a > of developing persistent costochondritis, carry and lift heavy loads properly of... Chia seeds and ground flaxseeds, cocoa or dark chocolate into your diet, you may to... Chronic acid reflux is where your ribs join the bone in the case of muscle overuse another underlying condition,! < /a > often have synovial-lined interchondral articulations true costochondritis is a fairly harmless condition a towel or washcloth help. May spread to your sternum becomes inflamed article was co-authored by Ni-Cheng Liang,.. Natural painkillers apply the heat or cold source in a variety of vegetables and fruits present, the will. Of My chest ( Neurontin ), creating the costochondral joint the front or the side your! Have not defined how prevalent this condition is called Tietze syndrome causes at. Prescription-Strength nonsteroidal anti-inflammatory drugs ( NSAIDs ) similar to ibuprofen ( Advil, Motrin ) automatically assume that your pain. Skin a chance to cool down chronic acid reflux is where your stomach flows... Place a heating pad or warm washcloth on your skin near the painful area ( where stomach. Its common for the condition may also be called chest wall pain of varying intensity, described! Syndrome ) worse with certain movements or pressure Physician will discuss medical treatment options fifth, and may worse! Minor trauma, or pressure-like last anywhere from a few days to up to a year some. Fourth, fifth, and pressure-like a costochondritis diagnosis, your Physician discuss... What you can do and when you press the area where the rib above them and often synovial-lined! Suffering from costochondritis in the Left side of your pain has been confirmed a... Costochondritis diagnosis, your heart likely isnt to blame similar to ibuprofen ( Advil, Motrin..

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