Definition:
Pectus excavatum a Latin term meaning hollowed chest is the most common congenital deformity of the anterior wall
of the chest, in which several ribs and the sternum grow abnormally. It produces a caved-in or sunken appearance
of the chest. It is often present at birth and progresses during the time of rapid bone growth in the early
teenage years, but in rare cases does not appear until the onset of puberty.
Diagnosis:
Pectus excavatum is initially suspected from visual examination of the anterior chest. Auscultation of the chest
could reveal displaced heart beat and valve prolapse. There may be a heart murmur occurring during systole caused
by proximity between the sternum and the pulmonary artery. Lung sounds are often clear yet diminished due to
decreased base lung capacity.
Treatment:
Medical treatment is limited to surgery and ensuring defects involving the heart and/or lungs are controlled.
Before operation many tests are usually to be performed. These include, however are not limited to, a CT scan,
pulmonary function tests, and cardiology exams.
Symptoms and Signs:
The hallmark of the condition is a sunken appearance of the sternum. Then the heart is displaced and rotated.
Mitral valve prolapse could also be present. Base lung capacity will decrease.
Causes:
Researchers are currently unsure as to the actual cause of pectus excavatum but hypothesize genetic defect.
Approximately 37% of individuals with pectus excavatum have a first degree family member with the condition.
Physiologically, increased pressure in utero, rickets and increased traction on the sternum because of
abnormalities of the diaphragm have been postulated as specific mechanisms. Pectus excavatum is also a relatively
common symptom of Marfan syndrome
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