Why does my heart hurt upon waking up?

Young patients presenting with precordial pain should be evaluated for the following three categories of conditions: First, cardiac disorders—such as myocarditis or pericarditis—but the character of the pain is inconsistent with that typically seen in myocarditis or pericarditis. Second, musculoskeletal causes localized to the precordium should be prioritized, including costochondritis or intercostal neuralgia, both of which are commonly observed in young patients. Third, respiratory system disorders may occasionally produce similar symptoms.