Pain in the cardiac area with a sharp intake of breath is usually not very clearly related to the heart, and we need to consider whether the patient has a pneumothorax or pleurisy. At this time, we should ask the patient’s medical history, whether there is a previous history of pneumothorax, and whether the patient has a fever. An X-ray of the chest or a CT scan of the chest should be performed to confirm the diagnosis. If there is pain in the heart after inspiration, we should also consider the presence of intercostal neuralgia or costochondritis. Intercostal neuralgia can often involve 1-2 intercostal spaces, is a stabbing or burning pain, is persistent and non-episodic, and can be aggravated by coughing, forceful breathing, and body rotation. In costochondritis, there is also significant tenderness at the costal cartilages.