Tietze Syndrome is a benign inflammatory disorder effecting the costal cartlidges and often mimicking many of the symptoms associated with cardiac chest pain. Although the pathophysiology of Tietze Syndrome is poorly understood, it was previously thought to be associated with a viral infection aquired during cardio-thoracic surgery. However, recent studies have proven that it is possible to develop Tietze Syndrome in the absense of recent, if any, surgery.
Tietze Syndrome Symptoms
The symptoms commonly associated with Tietze Syndrome are closely related to cardiac chest pain, and therefore acute coronary syndrome treatment should be commenced until further diagnostic tests have been completed and cardiac involvement rulled out. These are the common symptoms associted with Tietze Syndrome: acute, sharp central chest pain, often radiating down one or both arms. Unlike costochondritis, which usually presents with only central chest pain, Tietze Syndrome routinely involves arm pain and discomfort. The patient will often complain about exacerbation of the pain during respiration and with movement. The patient may appear short of breath.
Tietze Syndrome is considered relatively benign in nature and should self resolve within 10-12 weeks, provided that the patient maintains good health otherwise, such as eating right, sleeping well, and maintaining normal deep respirations. One complication with Tietze Syndrome is that people will often take shallow breaths as a means of avoiding the pain associated with deep breathing. This will then lead to further infections, such as pneumonia and should be avoided.
Alexander Tietze, a German Surgeon first decribed the condition in 1921. At that time, it was thought to be associated with the surgery, but this has been disproved through further studies.
Tietze Syndrome Treatment
Tietze Syndrome itself is considered benign and should self resolve. As a paramedic, it is important to be aware of this disorder because it so closely resembles an acute myocardial infarction. In fact, it does this so well, that a paramedic, doctor, nurse and other clinicians should treat for an acute coronary syndrome until Tietze Syndrome has been unequivically diagnosed. Tietze Syndrome is most commonly seen in patients who have had radiotherapy to the chest, chemotherapy in general, previous cardio-thoracic surgery, younger persons under 18 years of age, and persons who have recently undergone serious strenuous exercise involving the muscles of the chest.
If you would like to learn more about how Tietze Syndrome compares to other types of chest pains, please visit my Chest Pain page.