The Clinical Syndrome

Precordial catch syndrome, also known as Texidor’s twinge, is a common cause of chest wall pain. Occurring most frequently in adolescents and young adults, precordial catch syndrome is the cause of anxiety among patients and clinicians alike, given the intensity of the pain and its frequent attribution to the heart. Precordial catch syndrome almost always occurs at rest, often while the patient is sitting in a slumped position on an old couch ( Fig. 66.1 ).

Precordial catch syndrome can be caused by prolonged sitting in a slumped position.

Distinct from other causes of chest wall pain, precordial catch syndrome is characterized by sharp, stabbing, needle-like pain that is well localized in the precordial region. Symptoms begin without warning, only adding to the patient’s anxiety, and they go away as suddenly as they came. The pain lasts from 30 seconds to 3 minutes, and it is often made worse by deep inspiration. Patients suffering from precordial catch syndrome usually outgrow the syndrome by the third decade of life.

Signs and Symptoms

No physical findings (e.g., flushing, pallor, diaphoresis) are associated with the onset of pain, although some patients suffering from precordial catch syndrome may demonstrate tenderness to palpation in the anterior intercostal muscles overlying the painful area. Because the pain is made worse with deep inspiration, the patient may become lightheaded from prolonged shallow breathing.