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precordial catch syndrome (PCS)

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Precordial Catch Syndrome (PCS), also known as Texidor’s twinge

  • a common cause of chest pain complaints in children and adolescents (1)
    • less common in adults
  • the chest pain associated with PCS is as a sharp pain typically below the left, but occasionally right, nipple or breast - the chest pain is typically intensified on inspiration
    • pain is localized and does not radiate
    • the chest pain generally lasts 30 seconds to 3 minutes and then is resolved as quickly as it began
    • frequency of episodes varies with respect to individual patients - some patients may experience daily symptoms
    • deep inhalation during a PCS attack may cause an increase in chest pain in many - however some patients have found that forcing themselves to breathe as deeply as possible will result in a "popping" sensation which quickly and completely resolves the PCS episode
    • PCS is often seen to occur during rest or a sudden change in posture - however it never occurs during sleep
  • aetiology is unknown
    • theorised that PCS may be secondary to compression of an intercostal nerve
    • there is a correlation of PCS to stress and anxiety
  • investigation:
    • a review points out that this is not a diagnosis of exclusion (1)
      • emphasis is placed on the need for taking a careful history to elicit the diagnostic features of the syndrome and performing a thorough physical examination
      • diagnostic testing is usually unnecessary - familiarity with the features of precordial catch syndrome should be helpful to primary care providers caring for children
  • treatment
    • no known cure for PCS
    • however PCS is also not believed to be dangerous (1)
    • if a patient has PCS should then it should not interfere with normal activity

Reference

  1. Gumbiner, C.Precordial catch syndrome. South Med J. 2003 Jan;96(1):38-41
 
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