Precordial Catch Syndrome

Precordial Catch Syndrome (PCS) is a common cause for a piercing pain behind the left rib cage in the chest, particularly affecting adolescents. Read about this condition in detail, including its potential causes, symptoms, diagnosis, and treatment options.

Precordial Catch Syndrome Definition

This is a disorder that commonly affects children and adolescents. It is a common cause of chest pain in individuals belonging to these age groups. It also affects adults, although less frequently.

The condition is often mistaken as a heart attack, due to the similarity of its symptoms with that of a cardiac arrest.

Precordial Catch Syndrome ICD 9 Code

The ICD 9 Code for this disorder is 786.51.

Precordial Catch Syndrome Synonyms

The disease is also referred to by other names, such as:

Picture of Precordial Catch Syndrome

Picture 1 – Precordial Catch Syndrome

  • Texidor’s twinge
  • Stitch in the side

Precordial Catch Syndrome Symptoms

The major symptoms reported by individuals affected by PCS include:

Chest pain

The pain is usually localized to the anterior chest and may range from dull to stabbing in intensity. The aching sensation is very annoying and typically worsens upon breathing deeply or during movement. However, a patient may also experience the painful sensations when inactive or at rest.

In most cases, the pain arises in the region just under the left nipple. This is the area where one may feel the heart beating most intensely on the anterior part of the chest. The sensation arises all of a sudden.

Aches for short duration

The pain is needle-like and usually lasts for anywhere between ½ a minute to 3 minutes in duration. However, a dull ache tends to persist even after the intense pain has subsided. The painful symptoms may also originate once or twice in a week. In rare cases, however, the aches may persist for up to 30 minutes and cause great discomfort to sufferers.

Affected individuals also suffer from spasms or cramps in their chest muscle.

Vision problems

The disorder also affects vision in sufferers. Patients suffer from blurry vision or even loss of vision for a few moments.

Popping sensation

While breathing deeply, patients may experience a popping or ripping sensation in their chest region. This usually makes the pain resolve abruptly.

In rare cases, PCS sufferers may also experience one or more of the following health issues:

  • Syncope
  • Near syncope
  • Shallow breathing
  • Flushing
  • Palpitations
  • Paresthesias
  • Mild headedness
  • Pallor

It is difficult to ascertain whether or not the condition would affect the daily activities of a patient. This is due to the fact that the severity of the ailment tends to vary from one person to another.

A chest pain can be an indication of some more serious underlying or impending ailment. This is true in case a person experiences any of the following symptoms:

  • Fever
  • Chest pain, extending to the left side of the arm or jaw
  • Acute anxiety along with pain, with the sensation of an impending disaster
  • Paleness or bluish discoloration of the fingernails or the lips
  • Catching the breath or pronounced difficulty in respiration, different from moderate pain during respiration
  • Heaviness in the chest
  • Cough, with phlegm
  • Rapid, irregular or pounding cardiac rate
  • Painful symptoms that refuse to subside even by a little measure even a day after administering Ibuprofen in regular dose

If taking some rest or having some medications fails to remedy these problems, individuals experiencing such symptoms should contact a professional healthcare provider at the earliest and seek proper diagnosis and treatment at the earliest.

Precordial Catch Syndrome Causes

The condition has been mainly found to affect people who lead a sedentary lifestyle or are inactive for the most part of the day. The exact etiology of this disorder is still unclear. Texidor and Miller, who discovered this disease in 1955, were the first ones to suggest that the pain characteristic of PCS arose in the parietal pleura situated in the lungs. Miller himself was a sufferer of this disease. Later, the disorder was also reported by Sparrow and Bird in 1978 and by Pickering in 1981 as well as Reynolds in 1989. It was Reynolds who first reported the disorder in children living in the U.S.

Later, Exeer suggested that the pain arises from the brief muscular spasm of the intercostals which may subside after the spasm relaxes. It was also proposed that the pain does not arise in the cardiac area – which made it different from a heart attack.

As per another theory, the causative factor for this pain is the result of the pinching of a nerve. According to another physician, poor posture and intense activity may also work as trigger factors for this pain.

Precordial Catch Syndrome Diagnosis

Once they have been thoroughly examined physically, people suspected of having PCS are frequently diagnosed by the following means:

  • Barium studies
  • Echocardiography
  • Electrocardiography
  • Radiography

The medical history of such individuals is also assessed carefully. The condition is typically not a cause of worry, unless it is associated to any other disorder.

During diagnosis, doctors often believe a pinched nerve to be the actual cause of the pain. It is often difficult to ascertain the condition while it is actually giving rise to the problems as the symptoms tend to appear and disappear so quickly.  Physicians are able to differentiate between a serious cardiac ailment and a case of PCS by talking with patients, asking about the symptoms and conducting a physical examination.

Precordial Catch Syndrome Differential Diagnosis

It is essential to conduct a proper diagnosis of this condition, so as to ensure that an affected individual is actually suffering from PCS and not some other disorder of a more severe nature. In case of PCS, the differential diagnosis involves ensuring that the symptoms experienced by a patient are not the result of:

  • Pulmonary pain
  • Cardiac pain
  • Gastrointestinal pain
  • Pain in the chest wall

The condition can easily be differentiated on the basis of its symptoms. Apart from PCS, various other painful conditions may also give rise to painful symptoms in the chest wall. Physicians should ensure that a patient is not suffering from any of these disorders that affect the costosternal joints:

  • Ankylosing spondylitis
  • Osteoarthritis
  • Psoriatic arthritis
  • Reiter’s syndrome
  • Rheumatoid arthritis

Precordial Catch Syndrome Treatment

There is no known cure for this disease. Most sufferers report that the pain resolves completely and all of a sudden, without the need to use any medications.

Image of Precordial Catch Syndrome

Picture 2 – Precordial Catch Syndrome Image

On the basis of the results obtained from diagnosis, PCS can be cured by simple remedial measures. These include:

  • Lying down on a bed with face downwards
  • Breathing in a shallow way when the pain originates
  • Breathing deeply all of a sudden, that serves to decrease the muscular spasms

The abovementioned steps help to provide patients with relief from the discomforting aches in chest.

Physicians do not need to provide patients with any medicine as the condition is temporary and usually lasts for a maximum duration of 3 minutes. Diagnosing the disorder in a proper way negates the panic associated with chest pain from the mind of a patient as well as his/her family members.

Precordial Catch Syndrome Management

The management of the condition mainly involves careful observation of a sufferer. The patient and/or his or her family members need to have a proper discussion about the disease with their physician. Physicians need to calm down family members and sufferers themselves who often tend to panic due to the nature of the chest pain. Once a physician has diagnosed the disorder to be PCS, he or she should convey the information to the patient (and family members) and properly explain its difference from other conditions that give rise to similar painful sensations in the chest.

Precordial Catch Syndrome Prognosis

PCS is usually benign in nature. Naturally, they do not threaten the life of a sufferer in any way. This is as true in case of children and adolescents as in adults. The symptoms of the disease tend to resolve as rapidly as they appear. Mortality rate is not associated with this condition. However, presence of associated disorders may be fatal for life of sufferers. Even then, life expectancy actually depends on the type and severity of the associated condition.

Precordial Catch Syndrome Prevention

As people with a sedentary or inactive life are more prone to this disorder, modification of lifestyle may help keep the condition away in most cases. An active and healthy lifestyle is recommended to such high-risk individuals as well as those who are actually suffering from the disease.

If you are experiencing a severe chest pain, get in touch with a physician as soon as possible. It is not advisable to ignore or delay treatment on suspecting yourself to be suffering from PCS – which tends to resolve after a point of time. The chest pain could be a sign of a more serious disorder. Naturally, proper diagnosis and treatment in time is essential for faster recovery from your discomforting sensations.

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