Pectus excavatum: echocardiographic, pathophysiologic, and surgical insights.
Patients with pectus excavatum (PEX) may be referred for echocardiographic examination for a variety of complaints including exercise intolerance, dyspnea, palpitations, or chest pain. It is therefore important for the echocardiographer to have an appreciation of the various abnormalities associated with this disorder. Echocardiographic imaging may reveal a number of structural alterations of the right ventricle as well as a reduction in right ventricular systolic function. Interestingly, a number of these abnormalities have also been described in patients with arrhythmogenic right ventricular dysplasia, although patients with PEX do not share a predilection for malignant ventricular arrhythmias. Additional echocardiographic abnormalities associated with PEX include prolapse of the mitral and/or tricuspid valves, Marfan's aortopathy, pericardial effusion, prominence of the crista terminalis, and possibly a number of congenital cardiac anomalies. This review discusses the echocardiographic abnormalities associated with PEX and their pathophysiologic significance. The effects of corrective orthopedic surgery on cardiac function are also discussed.
Department of Cardiology, Echocardiography Laboratory, Icahn School of Medicine at Mount Sinai, New York, New York.
Jeffrey J
JJ
Silbiger
Department of Cardiology, Echocardiography Laboratory, Icahn School of Medicine at Mount Sinai, New York, New York.
Aditya
A
Parikh
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005660:Funnel Chest / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D011300:Preoperative Care / Q000379:methods
Marfan's syndrome; arrhythmogenic right ventricular dysplasia; crista terminalis; echocardiography; mitral valve prolapse; pectinate muscles; pectus excavatum; right ventricular function