Costochondritis in pregnancy: rib pain, not your heart

By trimester

Weeks 1–13

1st trimester

Early pregnancy nausea and vomiting can strain chest-wall muscles and cartilage from repeated retching, which is one route to costochondritis-type pain even before any uterine growth is a factor. A new chest pain is still worth mentioning at a visit even if you suspect a musculoskeletal cause.

Weeks 14–27

2nd trimester

A persistent cough from a cold or allergies, or resuming upper-body exercise, can trigger or aggravate rib-cartilage pain in the middle trimester. Reproducible tenderness at the rib-to-breastbone junction is a helpful clue, but it does not replace a clinician confirming there isn't something else going on.

Weeks 28–birth

3rd trimester

Later in pregnancy, an enlarging uterus and shifting posture add mechanical strain that can overlap with or mimic costochondritis, which is one reason rib and chest-wall pain gets more common as you near your due date. Because normal late-pregnancy shortness of breath can coexist with chest wall pain, describe both clearly to your provider so each is evaluated on its own.

What does the evidence show for costochondritis?

• Costochondritis is inflammation of the cartilage connecting most ribs to the breastbone, producing sharp chest-wall pain that may spread to the back or stomach and often worsens with a deep breath or cough. 1
• Chest wall pain from costochondritis is usually reproducible with mild-to-moderate pressing at the upper costochondral junctions, a specific physical-exam finding clinicians use to help support this cause over others. 2
• People with costochondritis typically have normal vital signs and no shortness of breath, fever, or rash alongside the chest pain; a fast heart rate or low blood pressure should raise suspicion for a different cause instead. 2
• Common triggers include vigorous upper-body activity, coughing, or another strenuous activity, and more than 90 percent of cases meaningfully improve within 3 to 4 weeks with supportive care. 2
• Reproducible tenderness on its own does not rule out another cause happening at the same time, so a full history and a systematic examination of the entire chest wall are still part of evaluating pregnancy and postpartum chest pain properly. 3
• Heart attack warning signs include chest pain, heaviness, or discomfort that can spread to the arms, back, shoulders, neck, jaw, or upper abdomen, along with shortness of breath, sweating, nausea, or lightheadedness, and pain that does not ease with rest. 4

Costochondritis versus heart attack warning signs

When should I call my provider about costochondritis?

Seek emergency evaluation for chest pain accompanied by shortness of breath, sweating, nausea, dizziness, or pain spreading to the arm, back, neck, or jaw, and for any pain that does not ease with rest or feels different from a sore spot you can reproduce by pressing. A rapid or irregular heartbeat, fainting, or pain paired with a fast heart rate or low blood pressure also needs urgent care rather than reassurance. Because costochondritis is only confirmed after more serious causes are considered, regard any new or unfamiliar chest pain in pregnancy as a reason to call your provider or seek same-day evaluation rather than assuming it is musculoskeletal. None of these lists replace your own judgment: if this symptom worries you, that on its own is enough reason to check in with your healthcare provider.