Precordial catch syndrome, called PCS or Texidor’s twinge is a condition where the patient, usually a child or an adolescent, feels a pain in their chest. The pain usually lasts less than three minutes, but it’s not life threatening and causes no lasting damage. Precordial catch syndrome affects both males and females in equal numbers. Most people who have the condition outgrow it by the time they reach adulthood, though even in adulthood the attacks are less painful and further apart. It is a common disorder that is not curable as of 2018 but needs no real treatment.
What Is Precordial Catch Syndrome?
Given its name in 1955, precordial catch syndrome is a condition where the patient feels a sudden pain in an area of their chest. The condition was described by two doctors, one of whom suffered from the condition himself. The pain can be mild or intense enough for the patient or their parent to think that the episode is life-threatening. These intense pains are described as shooting or stabbing and can be so intense that the patient’s vision starts to blur. The pains usually come when the person is resting and are made worse when they breathe or move around.
The symptoms of precordial catch syndrome were recognized as far back as 1893, when it was called Huchard syndrome after a French doctor. The present name is derived from the word praecordia, which means “in front of the heart.”
Symptoms of Precordial Catch Syndrome
The symptoms of PCS begin suddenly on the left side of the patient’s chest. It is confined to a small area and doesn’t radiate out the way the pain of a heart attack does. Because breathing and moving makes the pain worse, the patient usually lies very still and tries not to breathe deeply until the pain passes. After the pain is gone it may be replaced by an ache, though the area is not tender.
There are no other physical changes after the attack, though the patient may be a bit lightheaded if they have breathed shallowly during it. They are neither pale nor flushed, and their pulse rate is normal.
How often the attacks come varies from one patient to the next. Some patients have one attack every day while some have several attacks per day. Attacks can also be weeks or months apart. There are patients who go for years between attacks.
Causes of Precordial Catch Syndrome
Doctors do not know the exact cause of precordial catch syndrome. Some believe it is because nerves in the chest are compressed or irritated for some reason. This nerve irritation may cause some muscles in the patient’s chest to cramp or go into spasm. Some doctors believe that the origins are in the pleura, the outer sac that surrounds the lungs and is attached to the chest wall.
Precordial catch syndrome is not caused by a problem with the heart nor a problem with the lungs. Even if the problem does start in the pulmonary pleura, there is still nothing wrong with the way the lungs are functioning.
Some doctors believe the trigger may be an injury, bad posture or even a growth spurt. A child who is anxious or stressed may also be at greater risk for PCS. It is not a symptom of a digestive problem.
Though precordial catch syndrome is harmless, the pain in the chest understandably causes anxiety, especially if the child hasn’t experienced it before. The child should still be seen by a doctor to simply rule out any problems with the heart or the lungs. They should also be taken to the doctor if the chest pain comes with nausea, a very bad headache, shortness of breath or lightheadedness.
If the cause of the pain is precordial catch syndrome, the doctor will discover this in short order after taking the child’s medical history. The doctor will ask:
- When the pain began and how long it lasted.
- How mild or intense the pain was.
- If any other symptoms accompanied the pain.
- How often does the patient have these symptoms.
Besides its pain, the worst thing about precordial catch syndrome is the anxiety it causes in children and adults, who may still believe that the patient has something wrong with their heart. This can cause the patient to refrain from necessary exercise or sports they might otherwise enjoy. Indeed, in at least one study some of the patients, who were children, did have heart conditions such as an innocent murmur, a venous hum or even a mild stenosis, but these conditions still would not cause the symptoms they experienced with precordial catch syndrome. The hearts of other children were perfectly normal.
Precordial Catch Syndrome Treatment
If the diagnosis is precordial catch syndrome, the patient does not need treatment. Interestingly, though breathing deeply worsens the pain, some patients find that breathing deeply eventually causes a “pop” to be felt in their chest. When this happens, the pain goes away.
Other remedies are sitting up and raising the elbows. Some patients get relief when they change their posture from a slouch to an upright position or when they lie down or massage their chest. Other patients report that their attacks are more frequent when they are dehydrated.
Some people take NSAIDs for the pain, even though the pain does not last long. There is no reason to take any sort of medication for precordial catch syndrome.
Precordial catch syndrome is one of those conditions that mystify doctors and researchers and can cause undue worry to patients and their families. The intensity of the pain would suggest that it is a serious condition, but it is not. It causes no damage to the body, and after a while most people outgrow it. Though precordial catch syndrome due to a growth spurt can’t be prevented, correcting the child’s posture, lowering their level of anxiety and keeping them hydrated can lower the frequency of attacks.