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With Pectus Excavatum the sternum is sunken inwards pushing organs slightly out of their normal position. My question is could this repositioning put additional pressure on the heart over time leading to an increased risk of cardio vascular disease or other circulatory related problems?

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This is a very interesting question. Thank you.

Just as a small background on pectus excavatum (PE) (also known as "funnel chest"). It is characterised by depression of the sternum that begins over the midportion of the manubrium and progressing inward through the xiphoid process:

enter image description here

(from http://www.mayoclinic.org/diseases-conditions/pectus-excavatum/multimedia/pectus-excavatum/img-20007723)

According to this study conducted in 947 patients, the most frequent symptoms of PE are:

  • Exercise intolerance
  • Chest pain
  • Poot endurance
  • Shortness of breath

Now to your question:

could this repositioning put additional pressure on the heart over time leading to an increased risk of cardio vascular disease or other circulatory related problems

Yes. Several studies based on echocardiography have shown that, most of the patients with PE have cardiac displacement to the left side and hence right ventricular dysfunction (which explains the shortness of breath, exercise intolerance, etc...). Patients often show right ventricular outflow obstruction and reduced right ventricular systolic function (particularly in patients with severe PE). The cardiac displacement and compression may lead to conduction abnormalities, such as bundle branch block.

Noteworthy, surgical treatment is associated with an improvement of these cardiac abnormalities and hence symptoms.

Sources: Brochhausen C, Turial S, Müller FKP, et al. Pectus excavatum: history, hypotheses and treatment options. Interactive Cardiovascular and Thoracic Surgery. 2012;14(6):801-806. doi:10.1093/icvts/ivs045.

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