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In some cases, lots of forceful coughing -- like from a bout of pneumonia -- can cause rib fractures. Most of the time, the broken rib is only broken in one place, and is an incomplete fracture, meaning not all the way through the bone. Completely broken ribs may or may not move out of place. If they do move, they're called displaced rib fractures and are more likely to puncture lungs or damage other tissues and organs. Ribs that stay in place -- usually ribs that are not completely broken in half -- are called nondisplaced rib fractures.
A sharp piercing pain under your left rib cage that gets worse when you cough could be pericarditis. Your heart is protected by a sac called the pericardium and if this gets inflamed, it can cause sharp chest pain. According to doctors from the Mayo Clinic, it can be difficult to know the exact cause of pericarditis.