Research progress in the effects of pectus excavatum on cardiac functions

Abstract

BackgroundPectus excavatum, the most common chest wall deformity in children, accounts for nearly 90% of congenital malformations of chest wall. Initially, both parents and doctors paid more attention to the influence of this deformity on patient appearance and psychology. Following deeper studies of pectus excavatum, researchers found that it also affected cardiac functions. The purpose of this review aims to present recent research progress in the effects of pectus excavatum on cardiac functions.Data sourcesBased on aspects of CT, ultrasound cardiography (UCG) and MRI, all the recent literatures on the influence of pectus excavatum on cardiac function were searched and reviewed.ResultsModerate and severe pectus excavatum did have a negative effect on cardiac function. Cardiac rotation angle, cardiac compression index, right atrial and tricuspid annulus size, septal motion and myocardial strain are relatively effective indexes to evaluate cardiac function.ConclusionsPectus excavatum did have a negative effect on cardiac function; so surgeons should actively diagnose and treat such patients in clinical work. However, further research is needed on to explore the measures and indicators that can reflect the changes of cardiac function in patients objectively, accurately, effectively and timely.

Why is this child sick again?

“…Pectus excavatum is a fairly common diagnosis, affecting one in every 400 newborns and accounting for 90% of all congenital chest wall deformities. 5,6 It is diagnosed in males at a 4:1 ratio over females; however, it may be underdiagnosed in females when the presence of breast tissue makes it less apparent. 4 Pectus excavatum is characterized by a depression of the sternum, ribs, and costal cartilage into the thoracic cavity.…”

“…4 Pectus excavatum is characterized by a depression of the sternum, ribs, and costal cartilage into the thoracic cavity. 5 The pathogenesis is not clearly understood, but the two leading hypotheses involve overgrowth of costal cartilage or weak cartilage leading to chest wall collapse. A genetic component is likely, because up to 45% of cases appear to be inherited, with an autosomal recessive pattern being most likely.…”

“…In patients with pectus excavatum, this decrease in flexibility and compliance further compresses the thorax, which may impair cardiac function and lead to exercise intolerance, shortness of breath, and chest pain. 5 Other less-common symptoms include frequent respiratory tract infections, fatigue, tachypnea, and palpitations. 4 Although the case patient reduced his physical activity over the years before his diagnosis, it was unclear if he was able to identify progressive shortness of breath and exercise intolerance as contributing factors.…”

Features of Postural Body Stability in Children With Asymmetric Pectus Excavatum

“…На данный момент времени нет сомнений в том, что данный тип нарушения развития передней грудной стенки является функционально значимым из-за возможности формирования нарушений кардиореспираторных функций пациента при выраженных степенях деформации. Значительное снижение ретростернального пространства приводит к уменьшению объема грудной клетки, что, в свою очередь, обусловливает снижение жизненной ёмкости лёгких [2], нарушение функции сердечно-сосудистой системы [3] из-за компрессии сердца [4]. Это влечёт ухудшение качества жизни пациентов, проявляющееся снижением выносливости при физической нагрузке, затрудненным дыханием, одышкой, болью в груди [5].…”

Quality of life, psychological states, and personality traits in patients with pectus excavatum

“…Cardiac function evaluation using electrocardiography or echocardiography and lung function tests are also common methods to evaluate the severity of PE. 8 , 9 , 10 Compression of the right heart attributable to severe depression of the chest wall and highly restrictive ventilatory impairment are good indicators for surgery.…”