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Symptomatology

The deformity presents visually and can be observed in the first year of life, though it may not be noticed as a result of the absence of symptomatology which will become apparent in adolescence. Cases detected early need to be monitored at least to adolescence, given that is when sporting activity begins and the deficiencies caused by PE become evident.

Patients who suffer from this deformity may experience:

  • Lack of adaptation to physical activity
    The mediastinal deviation to the left involves a reduction in cardiac volume and, consequently, a lack of adaptation to the physical activity.
  • Breathing problems
    Reduction in exercise tolerance, tiredness and difficulty breathing caused by the reduction in pulmonary activity or the presence of respiratory infections such as pulmonary disease and, additionally, severe restrictions in pulmonary ventilation with a restrictive pattern.
  • Cardiac alterations
    Appearance of precordial pain, palpitations, syncope and arrhythmia.
  • Morphological effects on the spinal column
    Pectus Excavatum often presents with scoliosis which may cause: chest or lumbar pain.
    In all scoliosis cases there is a certain degree of sternal rotation, which means the ribs rotate the vertebrae, leading to a deformation of the rachis – and not the other way round.  All patients are born with scoliosis-free PE and this deformity appears over time in asymmetric cases.
  • Psychological disorders
    Many people affected by chest deformity present with behavioural disorders, with a tendency towards loneliness and social awkwardness.

Other presentations

Many cases present with a mild form of Poland with pectoral hypoplasia of the breast and nipple (usually on the right) which worsens over time and is exacerbated in puberty – particularly in female patients.

PECTUS EXCAVATUM PATIENT TYPE

  1. Asymptomatic patients with non-progressive mild to moderate deformity.
  2. Asymptomatic patients presenting severe, progressive chest malformation.
  3. Symptomatic patients with severe, progressive malformation, presenting signs of pulmonary or cardiac compression.
  4. Patients with Pectus Excavatum and other associated syndromes, such as Marfan syndrome or Poland syndrome, and severe cardiac anomalies.