Precordial Catch Syndrome

Authored by Peer reviewed by Dr Krishna Vakharia
Originally published Meets Patient’s editorial guidelines

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Although precordial catch syndrome is a harmless cause of chest pain, there are many other causes of chest pain, some of which are serious and need urgent medical attention.

Precordial catch syndrome (PCS) is condition which causes a sharp stabbing pain in the chest. These typically get worse with breathing in, and occur within a small area of the chest. The frequency of episodes of pain varies from only occasionally to experiencing daily symptoms.

Precordial catch syndrome is not caused by anything wrong with the heart. It is not serious (benign), and causes no harm. Spells of pain usually last less than a few minutes and sometimes only seconds before resolving as quickly as it began. The pain typically begins at rest and there are no other symptoms.

However, the pain may lead to anxiety, because other conditions that may produce similar symptoms include angina, pericarditis, pleurisy, and an injury to the chest.

Precordial catch syndrome is a common cause of chest pain in children, including children as young as 6 years, and teenagers, often occurring during the growth spurt.

Precordial catch syndrome in adults

Precordial catch syndrome is much more common in children and adolescents than in adults. The condition causes sharp stabbing pains in the chest, typically below the left nipple or breast, but occasionally below the right nipple or breast.

If the pain occurs regularly, it may lead to a worry of the pain occurring, and feeling scared to breathe deeply and take shallow breaths in order to prevent future episodes of the chest pain. However, sometimes forcing a very deep breath in will result in a "popping" sensation which quickly and completely resolves the episode of chest pain caused by precordial catch syndrome.

The underlying cause is not known but the cause seems to be within the chest wall, such as irritation of a nerve in the chest wall (intercostal nerve). Precordial catch syndrome often occurs during rest or a sudden change in posture, but never occurs during sleep.

Can stress cause precordial catch syndrome?

Psychological stress and anxiety are associated with precordial catch syndrome. Both stress and anxiety increase the likelihood of getting chest pain due to precordial catch syndrome, but the chest pain then often causes stress and anxiety because of worry whether there is anything more serious causing the pain, such as a heart problem.

A sharp stabbing pain in the chest is the only symptom of precordial catch syndrome. The pain typically gets worse with breathing in and occurs within a small area of the chest. Spells of pain usually last less than a few minutes. Typically it begins at rest and there are no other symptoms.

Is precordial catch syndrome dangerous?

Precordial catch syndrome is not a serious or dangerous condition. It is not caused by anything wrong with the heart. However chest pain may be caused by a number of dangerous conditions, such as a heart attack, so it is important to seek emergency help (call 999 in the UK) if there are any other symptoms such as feeling unwell, breathless, feel lightheaded, sweaty or feeling sick (nausea). See the leaflet on Chest Pain for further information.

Precordial catch syndrome is relatively common, and children between the ages of 6 and 12 are most often affected. It is much less common in adults.

How common is precordial catch syndrome in adults?

It is not known how common precordial catch syndrome is in adults or children. It is likely that many people get occasional episodes of precordial catch syndrome without seeking any medical advice from the primary care health team or hospital.

The diagnosis of precordial catch syndrome is based on the symptoms and, if necessary, investigations to rule out the possibility of any serious condition, such as heart attack or pulmonary embolism. Therefore, if there is any doubt about the diagnosis, tests such as blood tests, an electrocardiogram (ECG) and a chest X-ray might be needed.

Although precordial catch syndrome doesn’t lead to other health conditions, it can cause anxiety. Precordial catch syndrome does not cause any other complications.

There is no treatment necessary for precordial catch syndrome and the treatment is essentially just reassurance, because the pain generally resolves without any specific treatment. As precordial catch syndrome is not dangerous or life-threatening, there is no reason to take any medication. Precordial catch syndrome should not interfere with normal activities.

Precordial catch syndrome tends to mainly affect children and teenagers only. Most people outgrow it by the time they are young adults. Painful episodes usually become less frequent and less intense as time goes on. While it may be uncomfortable, precordial catch syndrome is harmless.

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Further reading and references

  • Chest pain; NICE CKS, August 2022 (UK access only)

  • Leung AK, Robson WL, Cho H; Chest pain in children. Can Fam Physician. 1996 Jun42:1156-60, 1163-4.

  • Chun JH, Kim TH, Han MY, et al; Analysis of clinical characteristics and causes of chest pain in children and adolescents. Korean J Pediatr. 2015 Nov58(11):440-5. doi: 10.3345/kjp.2015.58.11.440. Epub 2015 Nov 22.

  • Cayley WE Jr; Diagnosing the cause of chest pain. Am Fam Physician. 2005 Nov 1572(10):2012-21.