Affiliation:
1. Department of Pulmonary Disease Service (MCHE-ZDM-P), San Antonio Uniformed Services Health Education Consortium,
3551 Roger Brooke Dr, JBSA Ft. Sam Houston, TX 78234, US
Abstract
Abstract:
Evaluation of patients with pectus excavatum has primarily been focused and, especially
the pediatric population who undergoes surgical correction of sternal defects mainly for cosmetic
reasons combined with exercise-limiting symptoms. The extent of cardiopulmonary improvement
in this population based on cardiac imaging, pulmonary function testing, and cardiopulmonary exercise
testing may be highly variable. There is no current consensus on the limitations of cardiopulmonary
impairment or potential improvement from surgical repair in pediatric patients. Limited data
have been published in the medical literature on the evaluation of adults with pectus excavatum
who may also present with a variety of clinical symptoms. Adult patients with exercise limitation
and pectus excavatum may present with exertional dyspnea, chest discomfort, palpitations/tachycardia,
exercise-induced wheezing, and use of bronchodilators for asthma-like symptoms. While numerous
published review articles outline clinical evaluation and surgical treatment for younger patients,
comprehensive evaluation for these adult patients has not been fully elucidated. There is no
current consensus on the underlying cause of cardiopulmonary impairment in adult patients or their
potential improvement from surgical repair. This review focuses on the recommended evaluation
of adult patients to discern the potential cardiopulmonary limitations to exercise due to pectus excavatum,
especially in physically fit adults, such as active-duty military personnel. Two illustrative
cases are presented to describe the complexity of the evaluation for adult patients and the potential
need for surgical correction.
Publisher
Bentham Science Publishers Ltd.
Subject
Pulmonary and Respiratory Medicine
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