[33M] Experiencing sharp pain between rib cages with cough-induced aggravation

Patient Description

A 33-year-old male reports sharp pain located between the left and right rib cage, rated as 7 out of 10 in severity, worsening over the past 2 days. The pain notably increases upon bending over and coughing, with the latter causing the pain to spread upwards and to the middle. The area is tender to touch. No recent injuries, fever, cough, recreational drug use, or significant family history of gastrointestinal diseases were reported. The patient has a mild allergy to seafood but is not currently on any medications. No other symptoms were mentioned, and the patient is unsure of their past medical history.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint — where your ribs and breastbone are joined by rubbery cartilage. Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

    • Treatment typically involves nonprescription pain relievers and rest.
  • Pleurisy: This is a condition in which the pleura — a membrane consisting of a layer of tissue that lines the inner side of the chest cavity and a layer of tissue that surrounds the lungs — becomes inflamed. This can cause sharp chest pain that worsens during breathing or coughing.

    • Treatment involves addressing the underlying cause of the pleurisy and may include anti-inflammatory drugs or other medications.
  • Gastroesophageal reflux disease (GERD): This is a chronic condition in which stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause chest pain.

    • Treatment typically involves lifestyle changes and over-the-counter medications.

What you can do

  1. Rest and avoid physical activity to see if your symptoms improve.
  2. Over-the-counter pain relievers such as ibuprofen can help reduce the pain.
  3. If you suspect GERD, try avoiding spicy foods, caffeine, and alcohol, and see if your symptoms improve.
  4. Regardless of the cause, it's important to seek medical attention if your symptoms persist or worsen.

What you should look out for

Reasons to seek immediate medical attention:

  • Severe chest pain
  • Chest pain accompanied by trouble breathing or dizziness
  • Chest pain that spreads to your jaw, left arm, or back
  • Chest pain that gets worse when you exercise or exert yourself
  • New or different symptoms

Remember, I'm an AI and this advice is based on the information you've provided. It's always a good idea to consult with a healthcare professional for a formal diagnosis and treatment.

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8 mo ago


People Also Ask


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone, causing sharp pain in the chest. Treatment typically involves rest and nonprescription pain relievers like ibuprofen.


What are the symptoms and treatment options for pleurisy?

Pleurisy is an inflammation of the pleura, the membrane surrounding the lungs, causing sharp chest pain that worsens with breathing or coughing. Treatment involves addressing the underlying cause and may include anti-inflammatory drugs.


How can I differentiate between GERD and other causes of chest pain?

GERD-related chest pain is often accompanied by symptoms like heartburn and acid reflux. It can be differentiated from other causes by its association with eating and lying down, and it often improves with lifestyle changes and antacids.


When should I seek immediate medical attention for chest pain?

Immediate medical attention should be sought if you experience severe chest pain, chest pain with trouble breathing or dizziness, pain spreading to the jaw, left arm, or back, or pain that worsens with exercise.

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