Synonyms Texidor's twinge ICD-10 R07.2 | Specialty pulmonology ICD-9-CM 786.51 | |
Precordial catch syndrome (PCS) is a non-serious condition affecting the left side of the anterior wall of the chest. It is characterized by sharp chest pains, and usually affects children and adolescents, although it can occur, though less frequently, in adults. PCS manifests 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, or doing physical activity.
Contents
The symptoms of PCS are often 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 can lead to panic. This pain typically lasts from a few seconds to a few minutes although, in some cases, it can persist for up to 30 minutes. The frequency of episodes varies between patients, 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 pain medication are not required. 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. 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 sufferers may choose to refrain from some normal activities such as physical exercise, as this can exaggerate the pain, particularly if it occurs during physical activity.
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 in 1893 by Henri Huchard, a French cardiologist, who called it "précordialgie" (from the latin "praecordia" meaning "before the heart"), or "Syndrôme de Huchard" ("Huchard syndrome"). The term "precordial" was first coined in 1370 by another French surgeon, Guy de Chauliac.
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. 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 in English on PCS.