Open AccessPectus excavatum, not always as harmless as it seems
Author(s) -
Ron Winkens,
F. I. Guldemond,
Pierre Höppener,
Hans Kragten,
Yvonne van Leeuwen
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.10.2009.2329
Subject(s) - pectus excavatum , medicine , palpitations , sternum , rib cage , abnormality , thorax (insect anatomy) , physical examination , supraventricular tachycardia , tachycardia , cardiology , surgery , anatomy , psychiatry
Pectus excavatum is usually considered meaningless and without clinical significance. The following case may put a different complexion on the matter. A healthy 59-year-old male patient complained of progressive heart palpitations, fatigue and postural dyspnoea; bending over caused a clear increase of dyspnoea. At repeated examinations no overt abnormality or explanation was found, except a supraventricular arrhythmia and a nodal tachycardia. In the years to follow the symptoms led to considerable physical impairments. Finally, the patient himself, after searching the web, came up with a possible cause: his pectus excavatum. A lateral chest x-ray with the patient bending over and a lateral computed tomography of the thorax revealed an impression of the heart by the sternum. Ten years after the patient's signs and symptoms first appeared, a modified Ravitch procedure was carried out, after which the physical condition of the patient improved rapidly.