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Mar 6, - If you have acute pericarditis, the most common symptom is sharp, stabbing chest pain behind the breastbone or in the left side of your chest. Sharp, piercing chest pain over the center or left side of the chest, which is generally more intense when breathing in. Jan 3, - Pleurisy on the left side may cause pain under the left rib cage, but the main symptom is a sharp, stabbing pain when you breathe. See a doctor if you experience any intense chest pain during breathing.‎Causes · ‎Diagnosis · ‎Treatment.