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The Journal of the American Osteopathic... Feb 2017Osteopathic medicine places a special emphasis on the musculoskeletal system, and understanding how chest wall structure may influence function is critical. Pectus... (Review)
Review
Osteopathic medicine places a special emphasis on the musculoskeletal system, and understanding how chest wall structure may influence function is critical. Pectus excavatum is a common congenital chest wall defect in which the sternum is depressed posteriorly. Patients may present with complaints of chest wall discomfort, exercise intolerance, and tachycardia. The medical implications, diagnosis, and treatment options for patients with pectus excavatum are reviewed.
Topics: Echocardiography; Electrocardiography; Exercise Test; Female; Funnel Chest; Humans; Internal Fixators; Magnetic Resonance Imaging; Male; Manipulation, Osteopathic; Multimodal Imaging; Prognosis; Plastic Surgery Procedures; Respiratory Function Tests; Risk Assessment; Severity of Illness Index; Thoracotomy; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 28134952
DOI: 10.7556/jaoa.2017.021 -
Radiology Case Reports 2011In pectus excavatum, a developmental chest-wall deformity that affects approximately one in 400 births, the sternum is depressed inward and the ribs protrude anteriorly....
In pectus excavatum, a developmental chest-wall deformity that affects approximately one in 400 births, the sternum is depressed inward and the ribs protrude anteriorly. This deformity can compromise pulmonary and/or cardiac function. It can also produce a characteristic radiographic appearance on frontal radiographs, which may be mistaken for right-middle-lobe opacification from pneumonia or atelectasis. I present a case of pectus excavatum in a teenage female with characteristic imaging findings, and the disposition of the case.
PubMed: 27307886
DOI: 10.2484/rcr.v6i1.460 -
Differential diagnosis of rSr' pattern in leads V1 -V2. Comprehensive review and proposed algorithm.Annals of Noninvasive Electrocardiology... Jan 2015One of the more frequent dilemmas in ECG interpretation is the differential diagnosis of an rSr' pattern in leads V1 -V2 . We often face this finding in asymptomatic and... (Review)
Review
One of the more frequent dilemmas in ECG interpretation is the differential diagnosis of an rSr' pattern in leads V1 -V2 . We often face this finding in asymptomatic and otherwise healthy individuals and the causes may vary from benign nonpathological variants to severe or life-threatening heart diseases, such as Brugada syndrome or arrhythmogenic right ventricular dysplasia. In other cases, a normal variant of rSr' pattern can be misinterpreted as pathological after the occurrence of certain clinical events such as cardiac arrest or syncope of unknown cause. In this review we analyze in detail all the possible conditions, both benign and pathological that may explain the presence of this electrocardiographic pattern. We also propose a simple electrocardiographic algorithm for differential diagnosis.
Topics: Algorithms; Diagnosis, Differential; Electrocardiography; Electrodes; Funnel Chest; Heart; Heart Diseases; Humans; Hyperkalemia
PubMed: 25546557
DOI: 10.1111/anec.12241 -
BMJ Case Reports Feb 2011
Topics: Funnel Chest; Humans
PubMed: 22714628
DOI: 10.1136/bcr.12.2010.3581 -
The Journal of Thoracic and... May 2018
Topics: Funnel Chest; Humans; Multiple Pulmonary Nodules; Thoracic Wall
PubMed: 29653661
DOI: 10.1016/j.jtcvs.2018.02.040 -
Jornal Brasileiro de Pneumologia :... 2007Among the deformities of the thoracic wall,pectus carinatum has not received the same attention as has pectus excavatum. Few pulmonologists, pediatricians, and thoracic... (Review)
Review
Among the deformities of the thoracic wall,pectus carinatum has not received the same attention as has pectus excavatum. Few pulmonologists, pediatricians, and thoracic surgeons are aware of the approaches to treating this condition. As a consequence, patients with pectus carinatum are not referred for treatment. This deformity, with an incidence of 1:1000 teenagers, is oligosymptomatic. However, for aesthetic and emotional reasons, it accounts for a large number of medical appointments. Such patients are introverted and do not engage in physical activities, since they are unwilling to expose their chest, which also discourages them from going to the beach or to swimming pools. The diagnosis is clinical and visual, and details are obtained through chest X-rays and computed tomography. The treatment is based on a well-known organogram that summarizes orthopedic and surgical procedures. Dynamic compression, combined with physical exercises, is indicated for teenagers with flexible thorax in inferior and lateral pectus carinatum, with limited indication for those with superior pectus carinatum. For individuals of any age with rigid thorax, surgery is indicated for aesthetic reasons. Among the techniques described, the modified sternum chondroplasty stands out due to the excellent aesthetic results achieved.
Topics: Adolescent; Adult; Child; Cicatrix; Esthetics; Female; Funnel Chest; Humans; Male; Orthopedic Procedures; Sternum; Thoracic Wall
PubMed: 17982540
DOI: 10.1590/s1806-37132007000400017 -
Pediatric Reports Sep 2013Pectus excavatum, the most frequent congenital chest wall deformity, may be rarely observed as a sole deformity or as a sign of an underlying connective tissue disorder.... (Review)
Review
Pectus excavatum, the most frequent congenital chest wall deformity, may be rarely observed as a sole deformity or as a sign of an underlying connective tissue disorder. To date, only few studies have described correlations between this deformity and heritable connective tissue disorders such as Marfan, Ehlers-Danlos, Poland, MASS (Mitral valve prolapse, not progressive Aortic enlargement, Skeletal and Skin alterations) phenotype among others. When concurring with connective tissue disorder, cardiopulmonary and vascular involvement may be associated to the thoracic defect. Ruling out the concomitance of pectus excavatum and connective tissue disorders, therefore, may have a direct implication both on surgical outcome and long term prognosis. In this review we focused on biological bases of connective tissue disorders which may be relevant to the pathogenesis of pectus excavatum, portraying surgical and clinical implication of their concurrence.
PubMed: 24198927
DOI: 10.4081/pr.2013.e15 -
Turk Gogus Kalp Damar Cerrahisi Dergisi Jan 2024Chest wall deformities are congenital disorders characterized by abnormal development and appearance of the thoracic wall. The most common form is the pectus excavatum... (Review)
Review
Chest wall deformities are congenital disorders characterized by abnormal development and appearance of the thoracic wall. The most common form is the pectus excavatum deformity, known as shoemaker's chest. Pectus carinatum, known as pigeon chest, is the second most common deformity. In general, most patients are asymptomatic, but cardiopulmonary problems may accompany the disease. The indication for treatment is mostly cosmetic. Treating patients before they reach adulthood increases the chance of success. Surgical treatment can be open or minimally invasive.
PubMed: 38584783
DOI: 10.5606/tgkdc.dergisi.2024.25899 -
Journal of Thoracic Disease Mar 2021National data is limited on pectus excavatum, the most common chest wall deformity which is often repaired using the Ravitch and Nuss procedures. The purpose of the...
BACKGROUND
National data is limited on pectus excavatum, the most common chest wall deformity which is often repaired using the Ravitch and Nuss procedures. The purpose of the study was to describe demographics and outcomes of adult patients who underwent surgical repair of pectus excavatum via open and minimally invasive thoracoscopic methods.
METHODS
A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2015 to 2018 was performed, capturing patients 18 years or older with pectus excavatum as the postoperative diagnosis. Patients were placed into two groups of minimally invasive (Nuss) and open (Ravitch) repair procedure code. Baseline characteristics and postoperative outcomes were analyzed.
RESULTS
A total of 168 adult patients were captured. Most of these patients were white (84.52%) male (69.64%) and 26 years old on average. Median operative time was longer in the open repair group [250 (IQR, 173-308) versus 122 (IQR, 94-160) minutes, P<0.0001]. Median length of stay was five days (IQR, 4-6) in the open group and three days (IQR, 2-4) in the minimally invasive group (P=0.2873).
CONCLUSIONS
Complications after repair of pectus excavatum occur at similar rates between open and minimally invasive repair. Though minimally invasive repair decreases operative time and may decrease length of stay, the decision of type of procedure depends upon clinical scenario and factors unique to the individual patient.
PubMed: 33841932
DOI: 10.21037/jtd-20-2422