An outline of a man grasping at his chest overlaid on a drawing of a ribcage with inflamed joints.

RA Chest Pain (Costochondritis)

All morning sitting in my chair at my desk I felt a creeping but clear pressure growing in my chest. “Perhaps I worked out too hard this morning” I thought, since I had been doing much more weightlifting than ever before. I had felt good for a month or two, and hitting the gym hard felt amazing. No, it couldn’t be that.

Where was my chest pain coming from?

The chest pain was getting worse steadily, hour by hour. I’ve been an athlete for more than twenty years, and never has muscular pain from overuse come on that fast and felt as this did.

Worried, I got up from my desk and headed for the restroom. I quickly stripped off my shirt to inspect my chest in the mirror. Lightly with my fingers I probed where I felt the constricting pain. The slightest push sent a shooting pain across my chest and up to my shoulders.

The pain was intense and it was becoming difficult to breathe

Within the hour, my chest had become so tight it was hard to breathe. “Was I having a heart attack?” I thought, but I had no idea what a heart attack would feel like, and it seemed unlikely. But there was the pain, ever present, and getting worse. I sat down on the floor, gripping my chest, “I’m having a heart attack, right now” I finally concluded. It felt like my heart was slowing down the more my chest tightened up.

Was this chest pain a heart attack?

I got up and walked to my car, only a minute from my building. The pain was excruciating and felt potentially deadly. I was terrified.

The emergency room is only a few minutes from my office. I figured it would take me far less time (and cost far, far less) to just hop in my car and bolt over there than to call an ambulance and wait for them to arrive. In my mind, I had to go, now!

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Much to the chagrin of the parking attendant when I pulled into the valet line at the ER, I stumbled out my car, leaving the car running, and responded only with grunts when he asked me to wait my turn in line. I pointed to my chest, then nearly collapsed to the ground. He ran to get hospital attendants, who quickly came and got me with a wheelchair and took me straight in.

It wasn't a heart attack, but more joint pain

An IV was inserted in my arm immediately. The pain was severe enough, and the difficulty breathing heavy enough, that I could hardly communicate with the doctor or nurses when asked what was wrong. At times I felt my consciousness was coming and going. I could hear people, but it took a long time to process their words.

The doctor pushed on my chest, probing around for the precise location of the pain, and quickly ruled out a heart attack. No, the pain was in the sternocostal joints, right where the ribs attach to the breastbone. There is cartilage there that allows for the articulation of your breastbone and ribs, and they can get inflamed in a condition called costochondritis.

What is costochondritis?

Believe it or not, costochondritis can result from having RA. According to reports and medical information online, it can feel like a heart attack, though it is generally not dangerous and goes away on its own. Nonetheless, the pain can range from mild to severe, and in my case, the pain was overwhelming. I’ve broken a lot of bones, had third degree burns, and had eight major joint surgeries. I know pain, and this was up there. Sitting in the ER for a few hours I was a mess, truly just wrecked by this disease.

How was my costochondritis treated?

Thankfully I was administered a potent dose of an anti-inflammatory medication, and within an hour the pain had withdrawn enough that I could breathe more easily and talk to my wife and children who had rushed to the hospital and were clearly terrified. The inflammation took several days to go away completely, however. Breathing in deeply continued to hurt for more than a week, and I was not able to use my upper body to lift things for almost three weeks.

What is the relation between RA and costochondritis?

What a brutal illness. I’ve learned to live with episodes of throbbing RA inflammation in my hands, feet, shoulder, and jaw. No one ever told me that it could also affect my chest. Though inflammation of the chest is not common, a quick internet search will show you costochondritis happens enough in RA that most medical sites list it as possible occurrence.

Watch out for this one. If it does occur, seek medical attention to rule out all possible scenarios. From what I have gathered from researching it online, most people report costochondritis feels like a heart attack, or pain in the heart, just as I felt it, though in fact it is inflammation.

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