Texidor’s twinge

Precordial Catch Syndrome (PCS), also known as Texidor’s twinge

• a common cause of chest pain complaints in children and adolescents (1)
  • less common in adults
• the chest pain associated with PCS is as a sharp pain typically below the left, but occasionally right, nipple or breast - the chest pain is typically intensified on inspiration
  • pain is localized and does not radiate
  • the chest pain generally lasts 30 seconds to 3 minutes and then is resolved as quickly as it began
  • frequency of episodes varies with respect to individual patients - some patients may experience daily symptoms
  • deep inhalation during a PCS attack may cause an increase in chest pain in many - however some patients have found that forcing themselves to breathe as deeply as possible will result in a "popping" sensation which quickly and completely resolves the PCS episode
  • PCS is often seen to occur during rest or a sudden change in posture - however it never occurs during sleep
• aetiology is unknown
  • theorised that PCS may be secondary to compression of an intercostal nerve
  • there is a correlation of PCS to stress and anxiety
• investigation:
  • a review points out that this is not a diagnosis of exclusion (1)
    • emphasis is placed on the need for taking a careful history to elicit the diagnostic features of the syndrome and performing a thorough physical examination
    • diagnostic testing is usually unnecessary - familiarity with the features of precordial catch syndrome should be helpful to primary care providers caring for children
• treatment
  • no known cure for PCS
  • however PCS is also not believed to be dangerous (1)
  • if a patient has PCS should then it should not interfere with normal activity

Reference

1. Gumbiner, C.Precordial catch syndrome. South Med J. 2003 Jan;96(1):38-41