Symptomatic pectus excavatum in seniors: an exploratory study on clinical presentation and incidence in daily practice.

Objectives. Doctors all over the world consider a pectus excavatum usually as an incidental finding. There is some evidence suggesting that a pectus excavatum may cause symptoms in the elderly. It is not known how often a pectus excavatum occurs and how strong the relation is with symptoms. Methods. In hospitals and general practice data, we searched for evidence of a connection between cardiac symptoms and the presence of a pectus excavatum in a retrospective survey among patients in whom a pectus excavatum was found in a chest X-ray. In radiology reports, we searched for "pectus excavat(∗) " in almost 160000 chest X-rays. The identified X-rays were reviewed by 2 radiologists. Reported symptoms were combined to a severity sum score and the relation with pectus excavatum was assessed through logistic regression. Results. Pectus excavatum was found in 1 to 2 per 1000 chest X-rays. In 32% of patients (N = 117), we found symptoms that might reflect the presence of symptomatic pectus excavatum. We found a significant relation between the SPES sum score and the radiological level of pectus excavatum. Conclusions. A pectus excavatum found when examining the patient should not be neglected and should be considered as a possible explanation for symptoms like dyspnoea, fatigue, or palpitations.

Medical photography: a reliable and objective method for documenting the results of reconstructive surgery of pectus excavatum.

Patients with a pectus excavatum frequently experience medical problems such as dyspnoea, fatigue and palpitations. After surgical intervention most patients are alleviated of their symptoms. Pectus excavatum can easily be diagnosed by a proper inspection of the chest. In the Atrium Medical Center photographic documentation of the deformation of the chest is part of the treatment protocol before and after surgical correction of a pectus excavatum. In addition to the normal photographic routine two special recording techniques are applied: measuring the depth of the excavation with a rule, and documenting the depth of the excavation in a 3-D grid-projection image. The applied 3-D technique (raster stereography) can also be an asset to other medical specialty areas in which changes in body shape and appearance play a major role.