Intercostal neuralgia associated with internal mammary artery grafting

Two patients who underwent coronary artery bypass grafting in which the internal mammary arteries were used, developed chronic, atypical chest pain. After further investigation a diagnosis of intercostal neuralgia was made. It is thought that this condition is due to damage to the intercostal nerves when the internal mammary arteries are dissected. Intercostal neuralgia should be included in the differential diagnosis of chest pain after coronary artery surgery, as its recognition may save the patient unnecessary investigation and suffering.