Precordial catch syndrome

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ICD10 = ICD10|R|07|2|r|00
ICD9 = ICD9|786.51
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Precordial Catch Syndrome (PCS), also known as Texidor's twinge, is a common cause of chest pain complaints in children and adolescence. It also occurs less frequently in adults. PCS manifests itself as an intense, sharp pain typically below the left, but sometimes right, nipple or breast which is worse when taking breaths. This typically lasts 30 seconds to 3 minutes and then is resolved as quickly as it began.

History

The syndrome was first described and named by Miller and Texidor in 1955. 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. PCS has also been reported on by Pickering in 1981 and by Reynolds in 1989 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 typically located just below the left, or sometimes, right nipple or breast. The pain is localized 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 seconds to 3 minutes. The frequency of episodes varies by patient, sometimes occurring daily (or even multiple episodes each day). This is believed to be localized cramping of certain muscles groups in the locality.

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

The cause of PCS is unknown. It is speculated that it could be caused by the pinching of a nerve. 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.

Treatment

There is no known cure for PCS. However PCS is also not believed to be dangerous. Therefore PCS is generally seen as a mild inconvenience. 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 not interfere with normal activity, and there is no reason to use any form of medication.

References

* Gumbiner, Carl. Precordial Catch Syndrome. Southern Medical Journal. Volume 96, Number 1, January 2003
* Miller AJ, Texidor TA. Precordial catch, a neglected syndrome of precordial pain. J Am Med Assoc. 1955 Dec 3;159(14):1364–1365.