Tuesday, May 29, 2007

Precordial Catch Syndrome - Chest Pain for Kids

"Mom, my chest hurts when I breathe."

Bedtime. These things nearly always happen at bedtime and the temptation is to simply tell him to get his butt back to bed. Something in his voice tells me that this is more than the usual bedtime stall. His voice sounds small, pinched. I can tell that he is in pain.

Reassuring facts:

He is pink. Glowing almost. Clearly whatever is causing this hasn't affected his oxygenation.

His breath sounds are clear and equal and heart rhythm is regular and rate is about 90. Yes. When your mom is a nurse, the stethoscope comes in handy to rule out ominous things like spontaneous pneumothorax (although the pink lips offered more reassurance there) .

I gave him some water to sip and sat him on the couch for a few minutes to see which way this was going to go. Within a few minutes, his voice was back to normal, although he still complained of pain. When he tried to make a play for the TV controller to turn on "Deadliest Catch" I knew he was going to be OK and sent him to bed.

I can remember having similar symptoms as an adolescent. The pain only lasted a few minutes, but boy did it hurt at the time. Once he headed back up the stairs, I got on Google to find out what this is called.

Precordial Catch Syndrome
seems to be the most likely cause of this new symptom. He's the right age, the pain was exactly as described, and the symptoms passed quickly enough. Nobody seems to know what causes it. The pain is exclusively on inspiration (breathing in) and it resolves within minutes. It is possible to break the cycle by taking a deep breath, but I couldn't talk him into that tonight.

He's due for a physical shortly, so if this happens again (likely), we'll discuss it with his pediatrician then. I'm pretty sure he can make a case for sucking it up and taking that deep breath that will break the cycle. If it becomes more frequent, or is accompanied by more worrisome symptoms, we'll make an appointment to be sure this isn't something more serious.


Dr. Momentum said...

Oh, wow I remember those!

Never knew what to call them. I always wondered if it was a pneumothorax, but that didn't make sense.

In any case, it used to happen a lot and it always passed quickly enough that I never told anyone about it. I learned to just either breathe in quickly and get it over with or take in very small breaths to minimize the pain.

fox42 said...

Sure sounds like it. And as scary as the dickens!

Judy said...

It won't be as scary for him the next time it happens - and it's likely to happen again.

Pneumothorax crossed my mind, but you look like hell with a pneumothorax. I know people who have spontaneous pneumos. Hurts much more than precordial catch syndrome and you tend not to look so pink.

Anonymous said...

Hi im just some random that stumbled across this, i am 19/male and i have PCS i diagnosed it myself on the internet after 9 long years since i first had symptoms. Intense pain in the middle of the chest, left side, excruciating when breathing in normal or heavily. You have to take shallow breaths and it goes away eventually after 1 minute to 5 minutes. One method to stop the pain is to breathing shallowly and build up your breaths then do heavy breaths till you get a popping sensation in the area of pain, its like the nerve flicks back or pressure is released, who knows. The best thing to know is that it is not life threatening, when undiagnosed people think they are going to die, or they are having a heart attack etc therefore leading pcs to give the person a panic attack or lead to something else. Please get PCS diagnosed quickly so you understand that your life isn't in danger and that this problem can be managed with controlled breaths and relaxation followed by deep breaths to pop the pain away. Bye from Australia, melbourne

Anonymous said...

Hi I'm Another Random Person, I am 15/Female I Think I Have This,Pcs.
I Haven't Told Anyone About Any Further Symptoms Because They Said It Was Just Heartburn. But I Know Its Something More... The Pain Is Excruciating When I Have To Breathe. It Lasts Usually For A Few Minutes On End, But The Pain Lingers and I Get This Heavy Feeling Is It Supposed To Do That?

Judy said...

Who are the "they" who told you that you have heartburn?

Heartburn is caused by reflux which can be agonizing at times and which does not resolve with a deep breath or in a very short time as does precordial catch syndrome.

Precordial catch syndrome should stop hurting within a few minutes and without a feeling of "heaviness" or persistent pain. Heartburn CAN cause those symptoms, but if it does, it should be evaluated by your doctor anyway to see if you need to be on medication. Heartburn that severe can lead to esophageal erosions which needs medication to resolve.

There are other possibilities, but nobody is going to try to diagnose you over the internet. Let your parents know if the pain keeps coming back so you can get it checked out.

Anonymous said...

I am yet another random that has stumbled across this site. I am a 28/M and had a REALLY intense case this last night after sleeping for about an hour. I woke and could hardly take a breath without stabbing pain in my upper left lung. I was freaking out and thought I was going to die, thinking I might have a pulmonary embolism. It is hard to maintain shallow breathing when you think you are going to die. It lasted almost 5 minutes!......then it just vanished. I was releaved to say the least, then self diagnosed myself on the internet a few minutes afterward :) I feel bad for anyone who has to experience this.

Judy said...

As a rule, internet self-diagnosis for chest pain isn't a good idea -- except perhaps the fact like yours.

Calling 911 should be seriously considered any time chest pain is involved. If the pain lasts more than a few minutes, or when there is shortness of breath, nausea, etc it's best not to wait. The EMS folks would much rather arrive to have you tell them "never mind" than to find you dead.