Precordial Catch Syndrome
Precordial Catch Syndrome (PCS), also known as Texidor's twinge, is a common cause of chest
pain complaints in children and adolescents. It also occurs, though less frequently, in adults. PCS
manifests itself as a very intense, sharp pain typically at the left side of the chest which is worse when
taking breaths. Patients often think that they are having a heart attack which causes them to panic.
This typically lasts 30 seconds to 3 minutes, though some episodes last only a few breaths and in rare
cases can last up to 30 minutes. In all cases the pain is resolved quickly and completely. [1]
Contents
1 History
2 Symptoms
3 Causes
4 Treatment
5 References
History
The syndrome was first described and named by Miller and Texidor in 1955[2]. They reported the
condition in 10 patients, one being Miller himself. In 1978, PCS was discussed by Sparrow and Bird
who reported that 45 healthy patients suffered from it and that it was probably more frequent than
generally assumed[3]. PCS has also been reported on by Pickering in 1981[4] and by Reynolds in
1989[5] who did a report of the children in the US with the condition. These constitute the literature
available on PCS.
Symptoms
PCS has consistent characteristics. Its symptoms begin with a sudden onset of anterior chest pain on
the left side of the chest. The pain is localised and does not radiate like heart attack pain typically
does. Breathing in, and sometimes breathing out, often intensifies the pain. Typically this causes the
patient to freeze in place and breathe shallowly until the episode passes. Episodes typically last a
couple of seconds to three minutes. The frequency of episodes varies by patient, sometimes
occurring daily, multiple episodes each day, or years between episodes. This is believed to be
localized cramping of certain muscles groups. Intensity of pain can vary from a dull annoying pain to
intense pain causing momentary vision loss/bluriness.
Although deep inhalation during a PCS attack will likely cause an increase in pain, many have found
that forcing themselves to breathe as deeply as possible will result in a "popping" or "ripping"
sensation which quickly and completely resolves the PCS episode.
PCS episodes happen most often while sitting or lying down, and being inactive.
Causes
It is speculated that it could be caused by the pinching of a nerve and may be due to spasm of
intercostal muscles fibers (N.A.Exeer MD). There is also a correlation of PCS to stress and anxiety.
PCS is often seen to occur during rest or a sudden change in posture.
A bleb of the lung may be mistaken for PCS.
Treatment
There is no known cure for PCS. However PCS is also not believed to be dangerous. Therefore PCS
is generally not seen as a problem. Perhaps the worst part about PCS is the fear that this chest pain
is an indicator of a heart attack or other dangerous condition, so therefore a correct diagnosis of PCS
is a relief. PCS should only occasionally interfere with normal activity, and there is no reason to use
any form of medication.
References
1.Gumbiner, Carl H. (1 2003)."Precordail Catch Syndrome". Southern Medical Journal 96 (1): p. 38.
Retrieved 2009-04-08.
2. Miller, AJ; Texidor, TA (1955 Dec 3). "Precordial catch, a neglected syndrome of precordial pain." J
Am Med Assoc. 159 (14): 1364-1365. PMID 13271083.
3. Sparrow, MJ; Bird, EL (1978 Oct 25). "Precordial catch": a benign syndrome of chest pain in young
persons.". N Z Med J. 88 (622): 325-6. PMID 282484.
4. Pickering, D (1981 May). "Precordial catch syndrome". Arch Dis Child. 56 (5): 401-3.
5. Reynolds, James L. (1989 Oct). "Precordial Catch Syndrome in Children". Southern Medical
Journal. 82 (10): 1228-1230.
