What Causes Pain Under The Collar Bones?

Posted on Mon, 19 May 2014

Question: I have had a stitch like ache under both of my collar bones
for about three days along with heart burn. I am a very anxious person 42 years old and in other wise good health. Can this be from GERD or anxiety? I keep feeling panicky and worrying I am having heart issues.

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

Brief Answer:
Does not sound cardiac

Detailed Answer:
Dear XXXX

Thanks for your query. The description is not typical for heart disease and is likely non-cardiac. Certainly, with the burning sensation GERD would be higher in the differential diagnosis, but also anxiety can create physical manifestations such as the ones mentioned. You don't have from your history classic cardiovascular risk factors for heart disease, which is great.

That being said, many times it may be reasonable to do a stress test with imaging, for example an echocardiogram or nuclear test, to provide reassurance and "block" a potentially noxious cycle of anxiety (eg. if anxiety is the cause, then as you worry about the heart anxiety builds up and symptoms worsen).

Hope this helps, wish you the best,

Dr Brenes-Salazar MD
Mayo Clinic MN
Department of Internal Medicine
Division of Cardiology

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar