What Is Precordial Catch Syndrome?

If your child has sudden chest pain, then you might understandably be worried that something is wrong with their heart. However, there are several causes of sharp chest pain in children and youth that are not heart-related, including anxiety and muscle strain.¹ Another relatively uncommon, yet potentially alarming cause (until diagnosed) is precordial catch syndrome.

What is precordial catch syndrome?

Precordial catch syndrome is a benign (harmless) cause of chest pain, typically in children aged 6–12.  It’s sometimes called Texidor's twinge, as it was first described by Drs. Miller and Texidor in 1955.²

Though the exact cause of precordial catch syndrome remains unclear, the physicians who authored Evaluation and Treatment of Musculoskeletal Chest Pain in the medical journal Primary Care: Clinics in Office Practice attribute it to spasms within the muscles of the rib cage (the intercostal muscles).³

The syndrome is called “precordial” because it’s typically felt in the area in front of the heart (precordium). However, it's important to know that the heart is not involved in precordial catch syndrome, nor are the lungs.

Precordial catch syndrome is not serious, though its symptoms should be evaluated to rule out more serious conditions.

What are the symptoms of precordial catch syndrome?

Precordial catch syndrome is characterized by a sharp, stabbing, or needle-like pain in the chest,  typically localized below the left nipple. Symptoms may happen at rest or during activity that increases deep breathing. Severity can vary from a minor annoyance to intense enough to seek emergency medical care.

The pain comes on suddenly and goes away just as quickly, typically lasting between a couple of seconds and a few minutes. However, there have been cases where the pain was persistent, changing to a dull, vague ache over the left front of the chest.⁴

It is not associated with flushing, wheezing, or changes in pulse rate and rhythm.⁵

Some studies have shown an association between precordial catch syndrome and certain activities, such as swimming.⁶

Most people with precordial catch syndrome outgrow it by their early to mid-twenties, and it typically gets milder with time.⁷

What causes precordial catch syndrome?

The cause of precordial catch syndrome is poorly understood. The fact that the syndrome tends to go away when you stop growing points towards it being growth-related.

It’s not a physical defect, and it’s not contagious. 

Can precordial catch syndrome have complications?

While precordial catch syndrome is benign, it can cause some complications.

One feature of precordial catch syndrome is that it can hurt to take a deep breath, although breathing can sometimes make it go away.⁸ This can cause people to take very shallow breaths, which can lead to light-headedness. 

Children with precordial catch syndrome and their parents can develop health anxiety.⁹

The location of the pain can lead some people to believe they’re having a heart attack.

How to manage precordial catch syndrome

There’s no specific treatment for precordial catch syndrome. However, if the pain is unbearable, over-the-counter painkillers can help keep it under control. Taking slow, shallow breaths and relaxing might also provide some symptom relief.

There is some association with precordial catch pain and bending forward in a slouched posture. So, avoiding hunching over while having these sharp twinges may also lessen the pain.¹⁰

As anxiety can also cause chest pain, extensive testing may worsen anxiety. Speaking to a counselor or psychologist could help your child deal with the associated anxiety better.

When to talk to a doctor

While PCS is harmless, you shouldn’t assume your or your child's chest pain is PCS. Instead, talk to a doctor and get a proper diagnosis. In most cases, this only requires taking a medical history, as most doctors are familiar enough with the syndrome to diagnose it. However, your doctor may want to order some additional tests to be sure and rule out more serious causes of chest pain.

If your child is experiencing other symptoms, such as wheezing or flushing, seek emergency medical help, as this could indicate a more serious condition.

If you have a diagnosis of PCS, then you shouldn’t need further medical treatment unless other symptoms develop.

Your doctor should be able to reassure you and your child about PCS and why it’s nothing to worry about. If you or they still have anxiety, consider talking to a counselor. Anxiety about medical conditions in childhood can sometimes turn into health anxiety in adulthood when it’s harder to treat.¹¹

Most children grow out of PCS by their mid-twenties.¹²

Talk to a doctor if the chest pain happens after a blow to the chest or a fall.

The lowdown

Precordial catch syndrome is a harmless condition that can sometimes cause alarming chest pain in growing children and adolescents. Most outgrow it by their mid-twenties. There’s no specific treatment for precordial catch syndrome.

If your child has chest pain, consult a doctor to get a diagnosis and eliminate more serious conditions. PCS itself is fairly common and causes no long-term issues. However, it can cause anxiety that may warrant treatment from a therapist.

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References:

1. The Causes of Chest Pain in Children and the Criteria for Targeted Myocardial Enzyme Testing in Identifying the Causes of Chest Pain in Children - PMC

2. PRECORDIAL CATCH, A NEGLECTED SYNDROME OF PRECORDIAL PAIN | JAMA | JAMA Network

3. Evaluation and Treatment of Musculoskeletal Chest Pain - Primary Care: Clinics in Office Practice

4. Precordial Catch Syndrome in Elite Swimmers With Asthma

5. Texidor’s twinge a rare cause of benign paroxysmal chest pain

6. Precordial Catch Syndrome in Elite Swimmers With Asthma

7. Precordial Catch Syndrome

8. Texidor’s twinge a rare cause of benign paroxysmal chest pain

9. Precordial Catch Syndrome in Elite Swimmers With Asthma

10. Evaluation and Treatment of Musculoskeletal Chest Pain - Primary Care: Clinics in Office Practice

11. Practitioner review: health anxiety in children and young people in the context of the COVID-19 pandemic - PMC

12. Precordial Catch Syndrome