Precordial catch syndrome

Precordial catch syndrome
Classification and external resources
Specialty	Cardiology
ICD-10	R07.2
ICD-9-CM	786.51
Patient UK	Precordial catch syndrome

Precordial catch syndrome (PCS), also known as Texidor's twinge, is a common cause of chest pain 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, generally in the cartilage between the bones of the sternum and rib cage, which is worse when taking breaths. Oftentimes the symptoms are described as a "bubble in the chest" sometimes associated with the feeling of a "bubble popping" or cracking sensation which usually resolves the pain. Patients often think that they are having a heart attack which causes them to panic. This pain typically lasts from a few seconds to a few minutes, though, in some cases, it can persist for up to 30 minutes. The frequency of episodes varies from patient to patient; sometimes occurring daily with multiple episodes each day, or on a less frequent basis with weeks, months, or even years between episodes. On rare occasions, breathing in or out suddenly will cause a small "bubble" popping or cracking sensation in the chest, which results in the pain going away. In most cases the pain is resolved quickly and completely, and medication is not needed for the pain to subside. There is no known treatment or cure for PCS.

Signs and 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 localized and does not radiate like heart attack pain typically does. Breathing in, and sometimes breathing out, often intensifies the pain. Moving also 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. In some cases it lasts for 30 minutes. The frequency of episodes varies by patient, sometimes occurring daily, multiple episodes each day, or more spread out over weeks, months, or years between episodes. PCS is believed to be localized cramping of certain muscle groups. Intensity of pain can vary from a dull minor pain, to intense sharp pain possibly causing momentary vision loss/blurriness and often loss of breath.

Causes

The cause of PCS is unknown. Miller and Texidor suggested that the pain may originate in the parietal pleura of the lungs. The pain is most likely not of cardiac origin.

Treatment

There is no known cure for PCS. However PCS is not believed to be dangerous or life-threatening, and generally not seen as a major medical issue. Many see the worst part about PCS to be the fear that this chest pain is an indicator of a heart attack or other dangerous condition. PCS should only occasionally interfere with normal activity, and there is no reason to use any form of medication.

While there is no known cure, some patients have reported relief after slowly inhaling and holding their breath for a short while. Also, lifting the elbows while in an upright position reportedly decreases pressure on the region. Keeping the body hydrated is reported to decrease the frequency of these episodes as well, and ibuprofen may also help.

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 in American children has been discussed by Pickering in 1981 and by Reynolds in 1989. These constitute the literature available on PCS.

See also

• Pneumothorax