Precordial Catch Syndrome: Symptoms, Causes, Treatments

Precordial catch syndrome (PCS) causes sudden, sharp chest pain, usually in the upper left-hand side of the chest.

The pains are not accompanied by any other symptoms and usually affect children, teenagers, and young adults who are otherwise quite healthy.

Fortunately, though it can be scary, PCS is not serious and will resolve on its own within a few minutes or less. The chest pain can be sudden and intense, but it does not cause any lasting harm.

Although PCS is harmless, it can still be alarming for a child or teenager to feel a sudden stabbing pain near the heart region. While the pain lasts, it may hurt to take deep breaths.

The unexpectedness and intensity may cause some children or teens to feel panicked or worried that they are experiencing a medical emergency.

You and your child can rest assured that PCS is not a medical emergency, nor is it dangerous, but should always be evaluated by a pediatrician or provider to ensure no major issues.

Unless your child experiences additional symptoms, you can simply have them sit up straight and breathe slowly until the pain dissipates.

What Is Precordial Catch Syndrome?

Precordial catch syndrome (PCS), also called Texidor’s twinge, is a condition that causes sudden, sharp pains in the chest or ribs.

The condition is called precordial catch syndrome because the word “precordial” refers to being “in front of the heart”, which is most often where the pain is felt. 

PCS commonly occurs in children and young adults who are otherwise healthy. Children experiencing PCS may describe the pain as sharp, stabbing, or needle-like.

The pain may occur suddenly, when your child is resting or still, and it may feel worse if they take deep breaths. It typically comes and goes quickly, lasting no more than a few minutes at a time.

The pain is often localized in the left side of the chest, just below the left nipple (near the heart), though it may occur in other parts of the chest or ribs. 

PCS often goes unrecognized or undiagnosed, as there are no symptoms other than the pain. Luckily, there are no complications or long-lasting health effects of PCS.

What Are the Symptoms of PCS?

The only symptom of PCS is a sudden, stabbing pain in the chest, usually targeted around the upper left side of the ribs, near the heart. The pain covers a very small area, only lasts a few minutes (or less), and goes away on its own. 

While the pain is present, it may hurt to breathe deeply. Some people begin to take short, shallow breaths in an effort to avoid the pain.

The intensity of the pain may vary between different people. Some describe the pain as dull, annoying, or aching. Others experience severe pain that is stabbing and, in rarer cases, may cause temporary blurred vision.

Pain from PCS often occurs when a child or adolescent is at rest or doing very mild activity. The pain may come just once or multiple times in a day.

It often comes in isolated incidents and may not occur again, or it may happen suddenly after spans of days with no symptoms.

There are no other symptoms of PCS. A physical examination will not reveal any conditions or irregularities associated with PCS, and it does not cause long-term health issues.

Symptoms NOT associated with PCS

The pain from PCS does not cause tenderness in the region of the chest and does not spread to other areas of the chest, as would happen in the case of a heart attack.

People experiencing PCS do not show paleness or flushing of the skin. PCS does not cause wheezing, or any changes in pulse. 

Because PCS often leads to shallow breathing (as taking deep breaths becomes painful), a person may feel some lightheadedness as an indirect side effect—but PCS does not cause lightheadedness or dizziness directly.

PCS in Adults vs. Children

Although PCS can occur at any age, it most commonly occurs between 6-12 years of age. It’s not uncommon in teenagers and young adults, but it becomes far less common after the age of 20. However, adults can experience PCS.

What Causes a Child to Develop PCS?

Doctors are still unsure of any direct causes of PCS. Some studies have suggested that growth spurts may increase the likelihood of PCS, or that it may be associated with the nerves that line the chest wall.

The pain often comes when a child breathes in while at rest (sitting or lying down), slouching, or bending over.

It doesn’t happen while sleeping, and there is no clear trigger that causes the pain to start. Some doctors believe it may be more likely after a chest injury.

Is There a Link Between PCS and Anxiety?

PCS is not physically linked to anxiety, but experiencing the sudden, sharp pains of PCS may cause some children or teenagers to feel anxious.

Because it comes on quickly and the pain can be extremely sharp, it may cause a child or teenager to feel anxious that they are experiencing a more serious condition, such as a heart attack.

While your child may be alarmed by the sudden intensity of the pain, PCS is not associated with a heart attack, lung disease, or other major medical emergency.

The sharp pain can feel severe, particularly when breathing deeply, but it will resolve on its own within a few minutes.

Additionally, because the nature of the pain often makes it hurt to take deep breaths, your child may begin taking shallow, quick breaths in an attempt to ease the pain.

Shallow breathing is associated with feelings of anxiety in the body and can lead your child to feel lightheaded, which may fuel their anxieties.

PCS Diagnosis and Treatment

Diagnosis

Diagnosing PCS can be tricky, as it causes no symptoms other than the sharp, sudden pains, which are often gone by the time a person is able to see their doctor.

Fortunately, PCS is harmless. In most cases, if the child or teen is otherwise healthy, a doctor will be able to diagnose PCS without any tests.

To diagnose PCS, your doctor will first rule out more serious conditions that can cause chest pain. This includes doing a full physical exam, listening to the heart and lungs, and checking the chest region for any tenderness.

Your doctor will also ask about your child’s medical history and any underlying health problems.

If your doctor suspects a cause other than PCS, additional tests may be ordered. If your child is diagnosed with PCS, no additional tests are needed.

If your doctor diagnoses PCS and orders testing, seek a second opinion from another doctor to confirm whether tests are truly needed.

Treatment

Treatment is not required for PCS, as the pain will resolve on its own and does not have lasting health effects. 

There are some things you can do at home to help ease the pain when it occurs, particularly for children. 

• Encourage slow breathing: For some people, taking a slow, deep breath (although painful in the moment) causes the pain to stop afterward. This doesn’t work for everyone, so if your child won’t take deep breaths, you can instead have them focus on taking gentle and small breaths.

• Help them sit up: Try having your child relax and change their posture from a slouching or bent position to sitting upright or standing straight up. Encouraging your child to practice good posture, sitting up tall with shoulders back, may help to prevent PCS from occurring again.

• Try medication: If a child or adolescent is experiencing PCS somewhat regularly, your doctor may recommend anti-inflammatory medicine to help relieve the pain in the moment. You can get over-the-counter (OTC) anti-inflammatory drugs at your local pharmacy.

• Ease their fears: It may also help to reassure your child that this condition is harmless and will go away soon. This can help to alleviate anxiety and allow the child to relax, which may allow the pain to resolve sooner.

When to See a Doctor

If your child’s sudden chest pain goes away within a few minutes and isn’t accompanied by any other symptoms, call your pediatrician or make a visit when you can.

This is likely PCS, which is not serious and does not require immediate medical attention.

If your child has an underlying heart condition or develops other symptoms in conjunction with sharp chest pains, call your doctor or seek medical attention.

Similarly, see a doctor if the sharp pain in the chest continues without relief for longer than a few minutes, as it may be caused by something other than PCS.

When visiting your doctor, come prepared with answers for the following questions:

• When did symptoms begin?
• How long did the pain last?
• What did the pain feel like?
• What (if any) other symptoms came with it?
• How often have these symptoms occurred?

For parents, it may help to ask your child these questions in the moment or on the way to the doctor and record their answers to share with the doctor.

Call 911 or go to a hospital immediately if you or your child experience chest pain accompanied by any of the following symptoms:

• Nausea or vomiting
• Severe sudden headache
• Extreme shortness of breath
• Dizziness
• Chest pain that lasts longer than a few minutes

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