Precordial catch syndrome

{{Infobox medical condition (new)

| name = Precordial catch syndrome

| synonyms = Texidor's twinge

| image = Precordial catch syndrome Area.png

| caption = One of the areas more commonly affected in precordial catch syndrome

| field = Pediatrics, family medicine

| symptoms = Sharp, stabbing chest pain in a small area

| complications =

| onset = Sudden

| duration = 30 seconds to 3 minutes

| types =

| causes = Unclear

| risks =

| diagnosis =

| differential = Angina, pericarditis, pleurisy, chest trauma

| prevention =

| treatment = Reassurance

| medication =

| prognosis = Good

| frequency = Relatively common

| deaths =

}}

Precordial catch syndrome (PCS) is a non-serious condition in which there are sharp stabbing pains in the chest. These typically get worse with inhaling and occur within a small area. Spells of pain usually last less than a few minutes. Typically it begins at rest and other symptoms are absent. Concerns about the condition may result in anxiety.

The underlying cause is unclear. Some believe the pain may be from the chest wall or irritation of an intercostal nerve. Risk factors include psychological stress. The pain is not due to the heart. Diagnosis is based on the symptoms. Other conditions that may produce similar symptoms include angina, pericarditis, pleurisy, and chest trauma.

Treatment is usually via reassurance, as the pain generally resolves without any specific treatment. Precordial catch syndrome is relatively common, and children between the ages of 6 and 12 are most commonly affected. Males and females are affected equally.{{cite journal |author=Gumbiner CH |title=Precordial catch syndrome |journal=Southern Medical Journal |volume=96 |issue=1 |pages=38–41 |date=January 2003 |pmid=12602711 |doi=10.1097/00007611-200301000-00011}} It is less common in adults.{{cite web|last1=McMorran|first1=Jim|title=Precordial catch syndrome (PCS)|url=https://gpnotebook.com/en-us/simplepage.cfm?ID=x20070319114937295600|access-date=12 April 2021|website=General Practice Notebook|language=en}} The condition has been described since at least 1893.

Signs and symptoms

Characteristic symptoms include sharp stabbing pains in the chest. These typically get worse with breathing in and occur within a small area. Spells of pain usually last less than a few minutes. Typically it begins at rest and other symptoms are absent. Concerns about the condition may result in anxiety, with sufferers often fearing that the pain is a sign of a more serious condition. Similar anxieties in those who experience the syndrome on a regular basis may manifest as a worry of the syndrome itself happening, with patients feeling scared to take fuller breaths in fear of triggering a spell.

Causes

The underlying cause is unclear. Some believe the pain may be from the chest wall or irritation of an intercostal nerve. Psychological stress is correlated with precordial catch syndrome. The pain is not due to the heart.

Treatment

Treatment is typically reassurance, as the pain generally resolves without any specific treatment. Occasionally it goes away after a couple of breaths.

The pain is agitated by expansion and contraction of the chest. Taking a deep breath and allowing the rib cage to fully expand can relieve the pain, however it will feel unpleasant initially. At the point of full expansion, it can feel like a rubber band snap in the chest, after which the initial pain subsides.

There is no known cure for PCS; however, PCS is not believed to be dangerous or life-threatening. Many see the worst part about PCS to be the fear that this chest pain is an indicator of a heart attack or other more serious condition. As the condition is not dangerous or life-threatening, there is no reason to take medication, although some people may choose to refrain from some normal activities such as physical exercise, as this can exacerbate the pain, particularly if it occurs during physical activity.

History

The syndrome was first described and named in 1893 by Henri Huchard,{{cite book|url=https://gallica.bnf.fr/ark:/12148/bpt6k54958171/f732.item.r=Pr%C3%A9cordialgie.zoom|title=Traité clinique des maladies du coeur et des vaisseaux, par Henri Huchard,... Leçons de clinique et de thérapeutique, les cardiopathies artérielles, maladies de l'hypertension artérielle, maladies de l'hypertension artérielle, artério-sclérose généralisée, cardio-sclérose, aortites, angine de poitrine. 2e édition, entièrement remaniée|first=Henri (1844-1910) Auteur du texte|last=Huchard|date=9 May 1893|via=gallica.bnf.fr}} a French cardiologist, who called it "précordialgie" (from the latin "praecordia" meaning "before the heart"), or "Syndrôme de Huchard" ("Huchard syndrome").{{cite book|url=https://gallica.bnf.fr/ark:/12148/bpt6k57064606/f201.image.r=Henri%20Huchard%20pr%C3%A9cordialgie|title=Manuel du médecin praticien.... La pratique des maladies du coeur et de l'appareil circulatoire dans les hôpitaux de Paris, aide-mémoire et formulaire de thérapeutique appliquée / par le professeur Paul Lefert,...|first=Paul (18-19 ) Auteur du texte|last=Lefert|via=gallica.bnf.fr}}{{cite web|url=https://archive.org/stream/traitcliniqued02huch#page/198/mode/2up/search/Pr%C3%A9cordialgie|title=Traité clinique des maladies du coeur et de l'aorte|first=H. (Henri)|last=Huchard|date=9 May 1899|publisher=Paris, Doin|via=Internet Archive}} The term "precordial" had entered the French medical lexicon with the 1370 translation of Guy de Chauliac's Chirurgia magna.[http://www.cnrtl.fr/definition/pr%C3%A9cordialgie "précordialgie"]. Centre National de Ressources Textuelles et Lexicales. Previously, the Latin term "praecordia" had been used to refer to the diaphragm, a sense now obsolete.[https://web.archive.org/web/20170923051042/https://en.oxforddictionaries.com/definition/praecordia "praecordia"]. Oxford Dictionaries.

The Huchard syndrome was then studied more deeply by Miller and Texidor, medical practitioners at the Cardiovascular Department and the Department of Medicine at the Michael Reese Hospital in Chicago, in 1955.{{cite journal |author1=Miller, A.J. |author2=Texidor, T.A. |title=Precordial catch, a neglected syndrome of precordial pain |journal=Journal of the American Medical Association |volume=159 |issue=14 |pages=1364–5 |date=December 1955 |pmid=13271083 |doi=10.1001/jama.1955.02960310028012a}} They reported the condition in 10 patients, one being Miller himself. In 1978, PCS was discussed by Sparrow and Bird who reported 45 with it, and that it was probably more frequent than generally assumed.{{cite journal |vauthors=Sparrow MJ, Bird EL |title='Precordial catch': a benign syndrome of chest pain in young persons |journal=The New Zealand Medical Journal |volume=88 |issue=622 |pages=325–6 |date=October 1978 |pmid=282484}} PCS in American children has been discussed by Pickering in 1981{{cite journal |doi=10.1136/adc.56.5.401 |author=Pickering D |title=Precordial catch syndrome |journal=Archives of Disease in Childhood |volume=56 |issue=5 |pages=401–3 |date=May 1981 |pmid=7259265 |pmc=1627421}} and by Reynolds in 1989.{{cite journal |author=Reynolds JL |title=Precordial catch syndrome in children |journal=Southern Medical Journal |volume=82 |issue=10 |pages=1228–30 |date=October 1989 |pmid=2678498 |doi=10.1097/00007611-198910000-00007|s2cid=38707451 }} Gumbiner reviews PCS as a diagnosis in his 2003 article. Incidences of PCS in swimmers with asthma was analyzed in Hayes, et al.'s article in 2016, constituting the most recent English-language article on the syndrome {{as of|2023|05|lc=true}}.{{Cite journal |last=Hayes |first=Don |last2=Younger |first2=Bradley R. |last3=Mansour |first3=Heidi M. |last4=Strawbridge |first4=Heather |date=February 2016 |title=Precordial Catch Syndrome in Elite Swimmers With Asthma |url=https://pubmed.ncbi.nlm.nih.gov/26835568/ |journal=Pediatric Emergency Care |volume=32 |issue=2 |pages=104–106 |doi=10.1097/PEC.0000000000000715 |issn=1535-1815 |pmid=26835568}}

See also

References

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